Imaging-guided percutaneous vertebral and paravertebral lesion biopsy: A single center experience

Year 2020, Volume: 4 Issue: 1, 29 - 32, 02.01.2020

Onur Taydaş , Ömer Faruk Ateş , Osman Kındır

https://doi.org/10.28982/josam.670370

Abstract

Aim: Percutaneous needle biopsy has been used successfully in the diagnosis of vertebral, paravertebral and disc diseases in recent years as it is a minimally invasive, safe, and effective method. The aim of this study was to share our experience with imaging-guided percutaneous vertebral and paravertebral biopsies.

Methods: Images and data of 10 patients who underwent percutaneous vertebral and paravertebral biopsies between January 2018 and December 2019 were screened retrospectively through the hospital registry. The anatomical location of the lesion, guideline imaging method, number of samples taken, whether there were any complications after the procedure, needle diameter used, hemoglobin (Hb) values before and after the procedure were recorded.

Results: Among 10 patients included in the study, 3 (30%) were male and 7 (70%) were female. The mean age of the patients was 63.5 (8.6) years. Biopsies were performed under computerized tomography and ultrasound guidance in nine patients and one patient, respectively. The lesion was located at the thoracic level in 4 patients (40%) and at the lumbar level in 6 patients (60%). Two samples were obtained from all patients. There were no complications. The mean Hemoglobin (Hb) values before and after the procedure were 10 (1.1) mg/dL and 10.2 (1.4) mg/dL, respectively, which were similar (P=0.91). 18G needle was used in all patients.

Conclusion: Imaging-guided percutaneous vertebral and paravertebral biopsy is a safe and effective method which allows sampling for cytological, histological, and microbiological analysis. In the future, imaging techniques and biopsies will be increasingly used in the diagnosis of vertebral and paravertebral lesions.

Keywords

Percutaneous biopsy, Vertebrae, Imaging

Görüntüleme eşliğinde perkütan vertebral ve paravertebral lezyon biyopsileri: Tek merkez deneyimi

Abstract

Amaç: Bu çalışmadaki amacımız giderek daha yaygın olarak kullanılan görüntüleme eşliğindeki perkütan vertebral ve paravertebral biyopsi deneyimimizi paylaşmaktır. 

Yöntemler: Ocak 2018 - Aralık 2019 tarihleri arasında görüntüleme eşliğinde perkütan vertebral ve paravertebral biyopsi yapılan toplam 10 hastaya ait görüntüler ve veriler hastane bilgi sistemi üzerinden retrospektif olarak tarandı. Lezyon anatomik lokasyonu, kılavuz görüntüleme yöntemi, örnek alınma sayısı, işlem sonrası komplikasyon olup olmadığı, kullanılan iğne çapı, işlem öncesi ve sonrası hemoglobin (Hb) değerleri kaydedildi. 

Bulgular: Çalışmaya dahil edilen 10 hastadan 3’ü (%30) erkek, 7’si (%70) kadındı. Hastaların yaş ortalaması 63,5 (8,6) idi. 9 hastaya BT kılavuzluğunda, 1 hastaya ise USG kılavuzluğunda işlem yapılmıştı. 4 hastada (%40) lezyon torakal seviyede iken 6 hastada lezyon lomber seviyede idi (%60). Hastaların tamamından 2 kez örnek alınmıştı. Hiçbir hastada komplikasyon mevcut değildi. İşlem öncesi ortalama Hb değeri 10 (1,1) iken işlem sonrası Hb değeri 10,2 (1,4) olarak bulundu. İşlem öncesi ile sonrası saptanan Hb değerleri arasında anlamlı farklılık saptanmadı (P=0,91). Hastaların tamamında 18G iğne kullanıldı.

Sonuç:  Görüntüleme eşliğinde perkütan vertebral ve paravertebral biyopsiler güvenli ve etkin bir yöntem olup sitolojik, histolojik ve mikrobiyolojik analiz için örnek alınmasına imkan sağlamaktadır. Gelecekte görüntüleme yöntemleri ve biyopsi sistemlerinde yaşanacak gelişmelerle birlikte görüntüleme eşliğinde yapılan biyopsiler vertebral ve paravertebral lezyonların tanısında giderek daha fazla tercih edilecektir.

Keywords

Perkütan biyopsi, Vertebra, Görüntüleme

References

• 1. Pohlig F, Kirchhoff C, Lenze U, Schauwecker J, Burgkart R, Rechl H, et al. Percutaneous core needle biopsy versus open biopsy in diagnostics of bone and soft tissue sarcoma: a retrospective study. Eur J Med Res. 2012;17:29.
• 2. Takenaka D, Ohno Y, Matsumoto K, Aoyama N, Onishi Y, Koyama H, et al. Detection of bone metastases in non-small cell lung cancer patients: comparison of whole-body diffusion-weighted imaging (DWI), whole-body MR imaging without and with DWI, whole-body FDG-PET/CT, and bone scintigraphy. J Magn Reson Imaging. 2009;30:298-308.
• 3. Suva LJ, Washam C, Nicholas RW, Griffin RJ. Bone metastasis: mechanisms and therapeutic opportunities. Nat Rev Endocrinol. 2011;7:208-18.
• 4. Yang SY, Oh E, Kwon JW, Kim HS. Percutaneous Image-Guided Spinal Lesion Biopsies: Factors Affecting Higher Diagnostic Yield. AJR Am J Roentgenol. 2018;211:1068-74.
• 5. Rimondi E, Rossi G, Bartalena T, Ciminari R, Alberghini M, Ruggieri P, et al. Percutaneous CT-guided biopsy of the musculoskeletal system: results of 2027 cases. Eur J Radiol. 2011;77:34-42.
• 6. Rimondi E, Staals EL, Errani C, Bianchi G, Casadei R, Alberghini M, et al. Percutaneous CT-guided biopsy of the spine: results of 430 biopsies. Eur Spine J. 2008;17:975-81.
• 7. Lis E, Bilsky MH, Pisinski L, Boland P, Healey JH, O'Malley B, et al. Percutaneous CT-guided biopsy of osseous lesion of the spine in patients with known or suspected malignancy. AJNR Am J Neuroradiol. 2004;25:1583-8.
• 8. Wu JS, Goldsmith JD, Horwich PJ, Shetty SK, Hochman MG. Bone and soft-tissue lesions: what factors affect diagnostic yield of image-guided core-needle biopsy? Radiology. 2008;248:962-70.
• 9. Puri A, Shingade VU, Agarwal MG, Anchan C, Juvekar S, Desai S, et al. CT-guided percutaneous core needle biopsy in deep seated musculoskeletal lesions: a prospective study of 128 cases. Skeletal Radiol. 2006;35:138-43.
• 10. Gul SB, Polat AV, Bekci T, Selcuk MB. Accuracy of Percutaneous CT-Guided Spine Biopsy and Determinants of Biopsy Success. J Belg Soc Radiol. 2016;100:62.
• 11. Kasalak O, Wouthuyzen-Bakker M, Adams HJA, Overbosch J, Dierckx R, Jutte PC, et al. CT-guided biopsy in suspected spondylodiscitis: microbiological yield, impact on antimicrobial treatment, and relationship with outcome. Skeletal Radiol. 2018;47:1383-91.
• 12. Pupaibool J, Vasoo S, Erwin PJ, Murad MH, Berbari EF. The utility of image-guided percutaneous needle aspiration biopsy for the diagnosis of spontaneous vertebral osteomyelitis: a systematic review and meta-analysis. Spine J. 2015;15:122-31.
• 13. Filippiadis DK, Charalampopoulos G, Mazioti A, Keramida K, Kelekis A. Bone and Soft-Tissue Biopsies: What You Need to Know. Semin Intervent Radiol. 2018;35:215-20.
• 14. Filippiadis D, Mazioti A, Kelekis A. Percutaneous, Imaging-Guided Biopsy of Bone Metastases. Diagnostics (Basel). 2018;8.
• 15. Gogna A, Peh WC, Munk PL. Image-guided musculoskeletal biopsy. Radiol Clin North Am. 2008;46:455-73.