CT-guided bone biopsy in a cancer center: experience with a new apple corer-shaped device

In this article we report our experience with CT-guided bone biopsy (CTGBB) using a new nondisposable bone biopsy device with in a uniform protocol for all lesions and compare our results with data from bone biopsies obtained with other techniques. With this biopsy device, the specimen is collected in a 20 x 2 mm chamber of an apple corer-shaped needle. In 46 consecutive cancer patients that were candidates for bone biopsy, 50 CTGBB procedures were performed and analyzed. Lesions with cortical defects and/or surrounding soft tissue infiltration were excluded. There were no complications. Of 50 CTGBB procedures, 90% were diagnostic. Four of the five inconclusive biopsies were repeated: All were conclusive, one malignant. Of 19 with CT-indistinguishable lesions (detected on MRI or isotope studies), 35% were malignant. Thirty-eight percent of the lesions were not accompanied by pain. The procedure was less painful than injection of the local anesthetic prior to biopsy in 90% of the cases. With the new device, CTGBB procedures can be carried out safely. Biopsy with the described technique has a high diagnostic output, better results than those of biopsy with reported uniform techniques, and equal results to the best results of combined techniques. If a lesion is not distinguishable on CT and/or not accompanied by pain, malignancy is not ruled out. CTGBB in the described technique is less or equally time consuming, less painful, and cheaper than reported for other bone biopsy procedures.