Diagnostic Outcome of Image-Guided Percutaneous Core Needle Biopsy of Sclerotic Bone Lesions: A Meta-Analysis

This systematic review and meta-analysis aimed to evaluate the diagnostic outcome (diagnostic yield and accuracy) of image-guided percutaneous core needle biopsy (CNB) of sclerotic bone lesions.

A computerized search of the PubMed and EMBASE databases was performed to identify relevant original articles on the use of image-guided percutaneous CNB of sclerotic bone lesions. The pooled proportions of the diagnostic yield and pooled accuracy estimates were assessed using random-effects modeling. We also performed subgroup analyses of the diagnostic yield according to the drill systems (battery-powered vs manual). Heterogeneity among studies was determined using the inconsistency index (I²). Meta-regression analyses were performed to evaluate the potential sources of heterogeneity.

Fifteen eligible studies, involving 969 sclerotic bone lesions for diagnostic yield, and 242 sclerotic bone lesions for diagnostic accuracy, were included. The pooled proportion of the diagnostic yield of image-guided percutaneous CNB of sclerotic bone lesions was 74% (95% CI, 62-84%), and the pooled accuracy estimate for differentiation between benign and malignant lesions was 87% (95% CI, 77-93%). In the subgroup analysis, the pooled proportion of the diagnostic yield of the battery-powered drill system (76.7% [95% CI, 64.0-85.8%]) was higher than that of the manual drill system (65.2% [95% CI, 58.0-71.8%]). In the meta-regression analyses, no variables were significantly different (p = 0.13-0.93).

In conclusion, we determined that image-guided percutaneous CNB of sclerotic bone lesions is an accurate diagnostic technique with good diagnostic yield, particularly when the battery-powered bone biopsy system is used.