Diagnostic Outcome of Image-Guided Percutaneous Core Needle Biopsy of Sclerotic Bone Lesions: A Meta-Analysis

Abstract

Objective: This systematic review and meta-analysis aimed to evaluate the diagnostic outcome (diagnostic yield and accuracy) of image-guided percutaneous core needle biopsy (CNB) of sclerotic bone lesions.

Materials and methods: A computerized search of the PubMed and EMBASE databases was performed to identify relevant original articles on the use of image-guided percutaneous CNB of sclerotic bone lesions. The pooled proportions of the diagnostic yield and pooled accuracy estimates were assessed using random-effects modeling. We also performed subgroup analyses of the diagnostic yield according to the drill systems (battery-powered vs manual). Heterogeneity among studies was determined using the inconsistency index (I²). Meta-regression analyses were performed to evaluate the potential sources of heterogeneity.

Results: Fifteen eligible studies, involving 969 sclerotic bone lesions for diagnostic yield, and 242 sclerotic bone lesions for diagnostic accuracy, were included. The pooled proportion of the diagnostic yield of image-guided percutaneous CNB of sclerotic bone lesions was 74% (95% CI, 62-84%), and the pooled accuracy estimate for differentiation between benign and malignant lesions was 87% (95% CI, 77-93%). In the subgroup analysis, the pooled proportion of the diagnostic yield of the battery-powered drill system (76.7% [95% CI, 64.0-85.8%]) was higher than that of the manual drill system (65.2% [95% CI, 58.0-71.8%]). In the meta-regression analyses, no variables were significantly different (p = 0.13-0.93).

Conclusion: In conclusion, we determined that image-guided percutaneous CNB of sclerotic bone lesions is an accurate diagnostic technique with good diagnostic yield, particularly when the battery-powered bone biopsy system is used.

Keywords: bone neoplasms; core needle biopsy; data accuracy; meta-analysis; sclerosis.