Bone marking for biopsy using radionuclide bone imaging

If bone biopsies are performed after the sites are located under radionuclide guidance, the chances of sampling the pathologic tissue are greatly improved. After bone scanning, two to three areas for biopsy are chosen and locating is done with 0.05 ml of Tc-99m in a tuberculin syringe under an Anger camera. Methylene blue-xylocaine is injected into the skin up to the periosteum for marking the site of the biopsy. Using this technique, 27 biopsies in 20 patients have been performed (four were open and 23 were closed needle). Pathology was found in 25 biopsies (92.6%), cancer in 22 (81.5%), benign lesions in three (11.1%), and normal bone in two (7.4%).