TITLE

Magnetic Resonance Imaging-Guided Percutaneous Biopsy of Musculoskeletal Lesions

AUTHOR(S)
Carrino, John A.; Khurana, Bharti; Ready, John E.; Silverman, Stuart G.; Winalski, Carl S.
PUB. DATE
October 2007
SOURCE
Journal of Bone & Joint Surgery, American Volume;Oct2007, Vol. 89-A Issue 10, p2179
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Bone, soft-tissue, and articular lesions are often well visualized by magnetic resonance imaging. Our goal was to evaluate the diagnostic performance of magnetic resonance imaging-guided biopsies of selected musculoskeletal lesions. Methods: In this retrospective case series, forty-five consecutive biopsies were performed in an open mid-field 0.5-1 interventional magnetic resonance imaging unit with a real-time guidance system. The biopsies were performed at twenty bone, eighteen extra-articular soft-tissue, and seven intra-articular soft-tissue sites. The main reasons for using magnetic resonance imaging guidance were the need to improve lesion conspicuity compared with that provided by other imaging modalities, the need for site-specific targeting within the lesion, and the need for real-time guidance. Samples were obtained with fine-needle aspiration, core-needle biopsy, or a combination of these techniques. An independent reference standard was used to confirm the final diagnosis. Diagnostic performance was evaluated on the basis of the diagnostic yield (the proportion of biopsies yielding sufficient material for pathological evaluation) and diagnostic accuracy (sensitivity, specificity, positive predictive value, and negative predictive value). Complications were identified as well. Results: The diagnostic yield was 91% (forty-one of forty-five biopsies yielded sufficient material for a diagnosis) overall, 95% (nineteen of twenty) for the bone lesions, 94% (seventeen of eighteen) for the extra-articular soft-tissue lesions, and 71% (five of seven) for the intra-articular soft-tissue lesions. With regard to the diagnostic accuracy, the sensitivity was 0.86, the specificity was 1.00, the positive predictive value was 1.00, and the negative predictive value was 0.76 in the overall group. The respective values were 0.92, 1.00, 1.00, and 0.86 for the bone lesions; 0.77, 1.00, 1.00, and 0.57 for the extra-articular soft-tissue lesions; and 1.00, 1.00, 1.00, and 1.00 for the intra-articular soft-tissue lesions. There was one complication: exacerbation of neuropathic pain related to a biopsy of a peripheral nerve sheath tumor. Conclusions: Magnetic resonance imaging-guided percutaneous biopsies of musculoskeletal lesions for which other imaging modalities might be inadequate have a good diagnostic performance overall. The performance can be very good for bone lesions, moderate for extra-articular soft-tissue lesions, and fair for intra-articular soft-tissue lesions. Level of Evidence: Diagnostic Level II. See Instructions to Authors for a complete description of levels of evidence.
ACCESSION #
27093993

 

Related Articles

  • An alternative clip-marking method for use after 14-gauge large core needle biopsy of the breast. Gordon, Paula // Canadian Association of Radiologists Journal;Apr2004, Vol. 55 Issue 2, p75 

    Discusses the use of pediatric titanium vascular clips as a clip-marking method for use after 14-gauge needle biopsy of the breast in Canada. Compatibility of the clips with magnetic resonance imaging; Ultrasonic or stereotactic-guided biopsy; Cost of the clips.

  • Role of fine-needle aspiration cytology and core needle biopsy in diagnosing musculoskeletal neoplasms. KAUR, IVREET; HANDA, UMA; KUNDU, REETU; GARG, SUDHIR KUMAR; MOHAN, HARSH // Journal of Cytology;Jan-Mar2016, Vol. 33 Issue 1, p7 

    Background: The management of musculoskeletal neoplasms requires an accurate diagnosis, histologic type, and degree of tumor differentiation. Aim: The present study was undertaken to compare the accuracy of fi ne-needle aspiration cytology (FNAC) and core needle biopsy (CNB) in the diagnosis of...

  • Performing MR-guided biopsies in clinical routine: factors that influence accuracy and procedure time. Hoffmann, Rüdiger; Thomas, Christoph; Rempp, Hansjörg; Schmidt, Diethard; Pereira, Philippe; Claussen, Claus; Clasen, Stephan // European Radiology;Mar2012, Vol. 22 Issue 3, p663 

    Objective: To assess the accuracy, the duration and factors that influence the duration of MRI-guided liver or soft-tissue biopsies. Methods: Nineteen liver biopsies and 19 soft-tissue biopsies performed using 1.5T-MRI guidance were retrospectively analysed. Diagnostic performance and...

  • MRI does not reduce biopsies in diagnosing breast cancer. Gottlieb, Scott // BMJ: British Medical Journal (International Edition);12/11/2004, Vol. 329 Issue 7479, p1362 

    Reports on a new study that suggests that MRIs do not reduce biopsies in diagnosing breast cancer. Study which examined the accuracy of breast MRI and mammography for the detection of cancer in patients; Finding that the MRI is a better detector than mammography but that the negative predictive...

  • MR-guided breast biopsy at 3T: diagnostic yield of large core needle biopsy compared with vacuum-assisted biopsy. Meeuwis, Carla; Veltman, Jeroen; Hall, Hester; Mus, Roel; Boetes, Carla; Barentsz, Jelle; Mann, Ritse // European Radiology;Feb2012, Vol. 22 Issue 2, p341 

    Objective: The purpose of this study was to evaluate two MR-guided biopsy techniques at 3 T, large core needle breast biopsy (LCNB) and vacuum-assisted breast biopsy (VAB) and to compare the diagnostic yield and rate of complications to determine the optimal biopsy technique at 3 T. Methods: 55...

  • Role of CT-guided core needle biopsy in the diagnosis of a gossypiboma: case report. Wan, Y. L.; Ko, S. F.; Ng, K. K.; Cheung, Y. C.; Lui, K. W.; Wong, H. F. // Abdominal Imaging;Nov/Dec2004, Vol. 29 Issue 6, p713 

    A 66-year-old woman with previous hysterectomy had dysuria and vaginal spotting for 1 month. Computed tomography showed a heterogeneous presacral mass with eccentric calcification. Biopsies of the bladder and vagina and transrectal biopsy of the pelvic mass yielded only inflammation. T2-weighted...

  • Arthroscopically Guided Jamshidi Needle Biopsy of Articular Cartilage: Potential Utility in the Evaluation of Disease Modifying Osteoarthritis Drugs (DMOADS). Wei, Nathan; Johnson, Lanny L.; Seely, B. Lynn; Delauter, Sheila K. // Journal of Applied Research;Summer2003, Vol. 3 Issue 3, p329 

    Purpose: Studies of disease-modifying osteoarthritis drug (DMOAD) safety and effectiveness have relied on surrogate markers of disease activity (medical history, physical examination, radiographs, and magnetic resonance imaging). These often have low interobserver reliability and provide no...

  • CT-guided needle biopsy for musculoskeletal lesions. Tsukushi, Satoshi; Nishida, Yoshihiro; Yamada, Yoshihisa; Yoshida, Masahiro; Ishiguro, Naoki // Archives of Orthopaedic & Trauma Surgery;May2010, Vol. 130 Issue 5, p699 

    We determined the diagnostic accuracy rate of 207 cases that underwent CT-guided needle biopsy for musculoskeletal lesions during the past 10 years, and describe the efficacy and indications of this method. We retrospectively analyzed a consecutive series of 207 cases that presented to our...

  • How to... perform bone marrow biopsy in children.  // Clinical Pediatrics;Apr1970, Vol. 9 Issue 4, p226 

    Presents guidelines for performing bone marrow biopsy in children. Indications; Sites for biopsy; Preparation of the child; Insertion of the needle biopsy; Care of the specimen.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics