Initial experience with percutaneous biopsies of bone lesions using XperGuide cone-beam CT (CBCT): technical note

• Published in: Radiologia medica Vol. 117; no. 8; pp. 1386 - 1397
• Main Authors: Carrafiello, G., Fontana, F., Mangini, M., Ierardi, A. M., Cotta, E., Floridi, C., Piacentino, F., Fugazzola, C.
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01-12-2012
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biopsy, Needle - instrumentation; Biopsy, Needle - methods; Bone and Bones - diagnostic imaging; Bone and Bones - pathology; Cone-Beam Computed Tomography - instrumentation; Cone-Beam Computed Tomography - methods; Diagnostic Radiology; Female; Humans; Imaging; Interventional Radiology; Male; Medicine; Medicine & Public Health; Middle Aged; Musculoskeletal Radiology; Neuroradiology; Radiography, Interventional; Radiologia Muscolo-Scheletrica; Radiology; Sensitivity and Specificity; Ultrasound; Young Adult; Cone-beam CT; XperGuide; Biopsia percutanea; Lesioni ossee; Bone lesions; Percutaneous biopsy
• ISSN: 0033-8362; 1826-6983
• DOI: 10.1007/s11547-012-0788-1

Purpose
This paper describes our preliminary experience with percutaneous bone biopsy under XperGuide conebeam computed tomography (CBCT) guidance.
Materials and methods
Seventeen patients (11 men and 6 women; mean age 57.8; range 17–81) with 17 bone lesions underwent biopsy with XperGuide CBCT (Philips Medical System, Best, The Netherlands). The mean diameter of the lesions was 2.32 cm (range 1–8 cm). Technical success (defined as the correct positioning of the needle within the lesion), diagnostic accuracy, sensitivity and specificity were evaluated. Complication rate was also recorded.
Results
The technical success rate was 100%. In 15 patients, a sample of adequate material for histopathological analysis to yield a definitive diagnosis was obtained; in two patients, the sample was inadequate for a definitive diagnosis. In one of these two cases, the lesion was closely followed up for 1 year, during which it remained stable in size, and as a result, it was considered a false positive; the other was considered a false negative. Diagnostic accuracy, sensitivity and specificity were 94.12%, 90.91% and 100%, respectively. No major complications were recorded; only one patient had slight bleeding, with a consequent small haematoma, which reabsorbed in about 15 days.
Conclusions
Bone biopsy under XperGuide CBCT guidance can be considered accurate as a result of the combination of real-time needle orientation and spatial resolution of CT fluoroscopy. Moreover, our results are encouraging in terms of complication rate, diagnostic accuracy, sensitivity, specificity and reduction of CT workload.