土岐, 俊一 National Cancer Center|Tokushima University 徳島大学 教育研究者総覧
Sone, Miyuki National Cancer Center
Yoshida, Akihiko National Cancer Center
西庄, 俊彦 Tokushima University 徳島大学 教育研究者総覧 KAKEN研究者をさがす
Gokita, Tabu Saitama Cancer Center
Kobayashi, Eisuke National Cancer Center
Nakatani, Fumihiko National Cancer Center
Chuman, Hirokazu National Cancer Center
Sugawara, Shunsuke National Cancer Center
Arai, Yasuaki National Cancer Center
Kawai, Akira National Cancer Center
Background: Image-guided percutaneous core needle biopsy (CNB) has been an important diagnostic procedure for musculoskeletal lesions. Here we surveyed the variety of diagnostic strategies available and assessed the clinical usefulness and limitations of image-guided CNB carried out by a multidisciplinary team comprising specialists in various fields.
Methods: We conducted a retrospective study of 284 image-guided CNBs among 1899 consecutive biopsy procedures carried out at our institution for musculoskeletal tumorous conditions, focusing on their effectiveness including diagnostic accuracy and utility for classification of specimens according to malignant potential and histological subtype as well as their correlation with biopsy routes.
Results: Among the 284 studied biopsies, 252 (88.7%) were considered clinically “effective”. The sensitivity for detection of malignancy was 94.0% (110/117) and the specificity was 95.3% (41/43). The diagnostic accuracy for detection of malignancy was 94.4% (151/160) and that for histological subtype was 92.3% (48/52). The clinical effectiveness of the procedure was correlated with the complexity of the biopsy route (P = 0.015); the trans-pedicular, trans-retroperitoneal and trans-sciatic foramen approaches tended to yield ineffective results. Repeat biopsy did not have a significant impact on the effectiveness of image-guided CNB (P = 0.536).
Conclusions: The diagnostic accuracy rates of image-guided CNB performed at multidisciplinary sarcoma units were usable even for patients who have variety of diagnostic biopsy procedures. It is important to establish and implement diagnostic strategies based on an understanding that complicated routes, especially for spine and pelvic lesions, may be associated with ineffectiveness and/or complications.
Journal of Orthopaedic Science
The Japanese Orthopaedic Association|Elsevier
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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