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Percutaneous Image-Guided Spinal Lesion Biopsies: Factors Affecting Higher Diagnostic Yield
So Yeon Yang1, Eunsun Oh1,2, Jong Won Kwon1,3
11 Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
AJR. American Journal of Roentgenology
|August 31, 2018
Summary
Percutaneous spinal biopsies achieve an 80% diagnostic yield. Lesion size, bone matrix, and final diagnosis significantly impact the success of biopsies for spinal tumors.
Area of Science:
- Radiology
- Oncology
- Pathology
Background:
- Percutaneous biopsy is crucial for diagnosing spinal lesions.
- Optimizing diagnostic yield is essential for effective patient management.
Purpose of the Study:
- To determine the diagnostic yield of CT- and fluoroscopy-guided percutaneous biopsies of spinal osseous lesions.
- To identify lesion-related and technical factors influencing diagnostic yield.
Main Methods:
- Retrospective review of 247 percutaneous spinal biopsies.
- Analysis of lesion characteristics (size, location, matrix), guidance modality, and physician experience.
- Statistical comparison using chi-square, Fisher exact test, and multivariate logistic regression.
Main Results:
- An overall diagnostic yield of 80% was achieved.
- Larger lesions (≥ 20 mm), lytic bone matrix, and metastatic lesions demonstrated higher diagnostic yields.
- Specific p-values: Lytic vs. sclerotic (p=0.004), lytic vs. isodense (p=0.031).
Conclusions:
- Percutaneous image-guided biopsy of spinal tumors has an 80% diagnostic yield.
- Lesion size, bone matrix, and final diagnosis are key factors influencing biopsy success.
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