Bone and Soft-Tissue Biopsies: What You Need to Know.

Area of Science:

• Musculoskeletal Radiology
• Interventional Radiology
• Oncology

Background:

• Percutaneous, image-guided musculoskeletal biopsy is a minimally invasive alternative to open surgical biopsy.
• It is a primary method for acquiring tissue and bone samples in many institutions.
• Indications include histopathologic/molecular assessment, malignancy exclusion, bone marrow examination, and infection investigation.

Purpose of the Study:

• To review the technical aspects, indications, and methodology of percutaneous image-guided bone biopsy.
• To assist interventional radiologists in performing these minimally invasive procedures.

Main Methods:

• Review of existing literature on percutaneous image-guided bone biopsy techniques.
• Emphasis on preprocedural workup, including imaging and laboratory studies (coagulation, platelet count).
• Discussion of antibiotic prophylaxis in selected cases.

Main Results:

• Diagnostic accuracy ranges from 66% to 98%, with higher yields for lytic, large, malignant lesions and multiple/long specimens.
• Complication rates are typically low, ranging from 0% to 10%, with a suggested threshold of 2%.

Conclusions:

• Percutaneous image-guided bone biopsy is a safe and effective technique for musculoskeletal tissue acquisition.
• The procedure offers high diagnostic accuracy and a favorable safety profile.
• This review provides guidance for interventional radiologists performing these minimally invasive biopsies.