Predictive Factors Influencing Diagnostic Yield in Image-Guided Bone Biopsies: A Retrospective Analysis

Öz

Aim: To evaluate the factors that influence the diagnostic yield of image-guided percutaneous core needle biopsy (CNB) for bone lesions. Method: A retrospective analysis was conducted on 211 patients who underwent 226 image-guided percutaneous core needle biopsies for bone lesions between June 2020 and June 2024. The variables evaluated included patient age, lesion location, the modality used for biopsy guidance (ultrasound vs. CT), and pre-biopsy imaging techniques (PET/CT, MRI). Results: Diagnostic adequacy was achieved in 70.1% of cases. Key findings revealed that patients with adequate diagnostic yield were significantly older than those with inadequate yield (p=0.001). Lesions located in the lower extremity were more frequently associated with inadequate diagnostic yield (p=0.029), and the use of CT guidance was more common in this group (p<0.001). Additionally, pre-biopsy MRI use was higher in the inadequate yield group (p=0.005), while pre-biopsy PET scan use was lower (p=0.034). Among patients who underwent pre-biopsy PET scans, those with adequate diagnostic yield had significantly higher SUV values compared to those with inadequate yield (p=0.004) Conclusion: This study highlights key factors influencing diagnostic yield in bone biopsies, providing insights that can guide clinical decision-making. Understanding these factors may help improve diagnostic yield, aiding in appropriate treatment planning for patients with bone lesions.

Anahtar Kelimeler

• Bone neoplasms
• image-guided biopsy
• computed tomography
• ultrasonography

Görüntüleme Eşliğinde Yapılan Kemik Biyopsilerinde Tanı Yeterliliğini Etkileyen Faktörler: Retrospektif Bir Analiz Çalışması

Öz

Amaç: Kemik lezyonları için görüntüleme eşliğinde yapılan perkütan kor iğne biyopsisinin tanı yeterliliğini etkileyen faktörleri değerlendirmek. Yöntem: Haziran 2020 ile Haziran 2024 arasında kemik lezyonları için 226 görüntüleme eşliğinde perkütan kor iğne biyopsisi uygulanan 211 hasta retrospektif olarak değerlendirildi. Hasta yaşı, lezyon lokalizasyonu, biyopsi rehberliğinde kullanılan modalite (ultrason vs. BT) ve biyopsi öncesi görüntüleme yöntemleri (PET/CT, MRI) gibi çeşitli değişkenlerin biyopsi yeterliliği üzerindeki etkisi araştırıldı. Bulgular: Olguların %70,1'inde (148/211) biyopsi sonucu tanısal açıdan yeterli bulundu. Daha ileri yaş grubunda tanısal yeterlilik oranı anlamlı olarak daha yüksek saptandı (p=0,001). Üst ekstremite ve aksiyal iskelet yerleşimli lezyonlarda tanısal yeterlilik daha yüksek bulundu. US rehberliğinde biyopsi yapılan olgularda, BT rehberliğine göre daha yüksek oranda yeterlilik sağlandı (p<0,001). Ayrıca, biyopsi öncesi MRI kullanımı yetersiz tanı gruplarında daha yüksekken (p=0,005), biyopsi öncesi PET/CT kullanımı daha düşük bulundu (p=0,034). Biyopsi öncesi PET/CT yapılan hastalarda, yeterli tanı sağlananların SUV değerlerinin, yetersiz tanı sağlananlara göre anlamlı derecede yüksek olduğu görüldü (p=0,004). Sonuç: Çalışma, kemik biyopsilerinde tanı yeterliliğini etkileyen faktörleri ortaya koymakta ve klinik karar verme sürecinde yol gösterici olabilecek önemli bilgiler sunmaktadır. Bu faktörlerin anlaşılması, tanı yeterliliğini artırarak kemik lezyonları olan hastaların tedavi planlamasına katkıda bulunabilir.

Anahtar Kelimeler

• Kemik neoplazmları
• görüntüleme eşliğinde biyopsi
• bilgisayarlı tomografi
• ultrasonografi
• iğne biyopsisi

Etik Beyan

Makale için etik kurul onayı alınmış olup yazarlar arasında çıkar çatışması yoktur.

Kaynakça

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