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. 2008 Jul;17(7):975-81.
doi: 10.1007/s00586-008-0678-x. Epub 2008 May 8.

Percutaneous CT-guided biopsy of the spine: results of 430 biopsies

Eugenio Rimondi  1 , Eric L Staals, Costantino Errani, Giuseppe Bianchi, Roberto Casadei, Marco Alberghini, Maria Cristina Malaguti, Giuseppe Rossi, Stefano Durante, Mario Mercuri
Affiliations

Percutaneous CT-guided biopsy of the spine: results of 430 biopsies

Eugenio Rimondi et al. Eur Spine J. 2008 Jul.

Abstract

Biopsies of lesions in the spine are often challenging procedures with significant risk of complications. CT-guided needle biopsies could lower these risks but uncertainties still exist about the diagnostic accuracy. Aim of this retrospective study was to evaluate the diagnostic accuracy of CT-guided needle biopsies for bone lesions of the spine. We retrieved the results of 430 core needle biopsies carried out over the past fifteen years at the authors' institute and examined the results obtained. Of the 430 biopsies performed, in 401 cases the right diagnosis was made with the first CT-guided needle biopsy (93.3% accuracy rate). Highest accuracy rates were obtained in primary and secondary malignant lesions. Most false negative results were found in cervical lesions and in benign, pseudotumoral, inflammatory, and systemic pathologies. There were only 9 complications (5 transient paresis, 4 haematomas that resolved spontaneously) that had no influence on the treatment strategy, nor on the patient's outcome. In conclusion we can assert that this technique is reliable and safe and should be considered the gold standard in biopsies of the spine.

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Figures

Fig. 1
Fig. 1
Thoracic spine (T7). Planning of the needle tract: transpeduncular approach. a Line 1 measures the distance between the spinous process and the skin insertion point. Line 2 measures the distance between the skin and the distal portion of the lesion. b CT control of the tip of biopsy needle (trap system needle). Line 1 shows the distance from the tip of the needle to the distal part of the lesion. The needle should be advanced to the most distal portion of the lesion in order to take as much diagnostic tissue as possible. Histological diagnosis: angioma
Fig. 2
Fig. 2
Cervical spine (C1) Lytic lesion of the right atlas process. Prone position: mid-posterior approach. a Planning of the needle tract with a lead marker attached to the skin. b Insertion of biopsy needle (bonopty set) inside the lesion. Histological diagnosis: benign inactive lesion, not further defined
Fig. 3
Fig. 3
Prone position: transpeduncular approach of T9. The centimetrated trocar of Craig-Kogler set is placed on the cortex of the rigth pedicle. Introduction through the trocar of the biopsy needle approaching the moth-eaten lytic lesion of the posterior right part of the vertebra. Histological diagnosis: metastasis of adenocarcinoma
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