Challenging bone biopsies: what radiologists needs to know

Area of Science:

• Radiology
• Orthopedic Surgery
• Pathology

Background:

• Bone biopsies are crucial for diagnosing bone diseases.
• Image-guided percutaneous biopsy is preferred over surgery due to its minimally invasive nature, accuracy, cost-effectiveness, and reduced patient morbidity.
• CT guidance provides excellent spatial resolution for precise needle placement in bone biopsies.

Purpose of the Study:

• To review challenging scenarios in CT-guided bone biopsy.
• To provide practical decision-making guidance for difficult bone biopsy cases.
• To illustrate techniques for biopsies in anatomically complex or radiographically subtle bone lesions.

Main Methods:

• Review of challenging CT-guided bone biopsy cases.
• Focus on lesions adjacent to critical neurovascular or spinal structures.
• Discussion of biopsies in densely sclerotic or CT-occult lesions.

Main Results:

• CT guidance is effective but presents challenges in specific anatomical locations.
• Strategies exist for navigating biopsies near critical structures.
• Techniques for sampling sclerotic or occult lesions are discussed.

Conclusions:

• CT-guided bone biopsy is a valuable tool, even in complex cases.
• Careful planning and technique are essential for successful biopsies in demanding situations.
• This review provides a framework for managing challenging CT-guided bone biopsies.