Factors in sample volume and quality of CT-guided vertebral biopsy: location and needle trajectory

To assess sample volume (by its length and diameter) and sample quality (judging by its integrity) in CT-guided vertebral biopsy due to lesion location and needle trajectory method as individual study variables each.

Of 48 patients, 25 were men and 23 were women; ranging from 33 to 85 years of age, with a median age of 65.5 years. The independent variables were primarily vertebral location and needle trajectory. Two cervical lesions were excluded from location analysis. We examined sample length and width, and macroscopic (5-scale) and microscopic (3-scale) scores as dependent variables. We did not encounter with any major complication and infection.

Median sample length and sample diameter were found to be 10 mm and 2 mm, respectively. No relation was observed between the dependent variables and location in the spine. There was a relation between sample length and needle trajectory (p=0.002) with values of 11 mm in the transpedicular method vs. 6 mm in the posterolateral method (p=0.01).

Transpedicular trajectory had an advantage over the posterolateral method as it provides a longer sample. We believe that transpedicular biopsy should be preferred. Nevertheless, studies are needed to validate the most advantageous standard access position in spine biopsies.