Percutaneous CT-guided sternal biopsy: factors affecting the diagnostic yield

Area of Science:

• Radiology
• Interventional Radiology
• Oncology

Background:

• Sternal lesions require accurate diagnosis, especially in oncologic patients.
• Percutaneous computed tomography (CT)-guided biopsy of sternal lesions is infrequently performed.
• Understanding factors influencing diagnostic yield is crucial for clinical practice.

Purpose of the Study:

• To evaluate the diagnostic yield of percutaneous CT-guided sternal biopsies.
• To identify factors impacting the success rate of these biopsies.

Main Methods:

• Retrospective review of 34 patients undergoing CT-guided sternal biopsy.
• Analysis of pre-biopsy CT density, lesion location, needle penetration, number of attempts, needle angle, final diagnosis, and operator experience.
• Biopsy success defined as a confident pathologic result; statistical comparison using Chi-square tests.

Main Results:

• Overall diagnostic yield was 64.7% (22/34), with 35.3% (12/34) non-diagnostic.
• Longer needle penetration distance correlated with higher diagnostic yield (P=0.031).
• Osteoblastic lesions (P<0.001), manubriosternal joint involvement (P=0.018), and obtuse needle angles (P=0.009) were associated with lower yields. Malignancy diagnosis yielded higher success rates (P<0.001).

Conclusions:

• CT-guided percutaneous sternal biopsy demonstrates a relatively lower diagnostic yield.
• Employing an acute needle approach angle may enhance biopsy success.
• Osteoblastic lesions and those in the manubriosternal joint present challenges for diagnostic yield.