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Case Reports
. 2021 Jul 1;16(9):2343-2346.
doi: 10.1016/j.radcr.2021.06.009. eCollection 2021 Sep.

CT-guided bone biopsy using electron density maps from dual-energy CT

Shota Yamamoto  1 , Shunsuke Kamei  1 , Kosuke Tomita  1 , Chikara Fujita  2 , Kazuyuki Endo  2 , Shinichiro Hiraiwa  3 , Terumitsu Hasebe  1
Affiliations
Case Reports

CT-guided bone biopsy using electron density maps from dual-energy CT

Shota Yamamoto et al. Radiol Case Rep. .

Erratum in

Abstract

Computed tomography (CT) -guided bone biopsy is a diagnostic procedure performed on the musculoskeletal system with a high diagnostic yield and low complications. However, CT-guided bone biopsy has the disadvantage that it is difficult to confirm the presence of tumor cells during the biopsy procedure. Recently, the clinical benefits of dual-energy CT (DECT) over single-energy CT have been revealed. DECT can provide material decomposition images including calcium suppression images, and effective atomic number (Zeff) and electron density (ED) maps. ED maps have been reported to indicate cellularity. A 61-year-old woman with a history of breast cancer surgery was admitted to our hospital and underwent a CT-guided bone biopsy of the right ilium using ED maps. As a result, she was diagnosed with breast cancer metastases of intertrabecular bone. A comparison of ED maps with a pathological specimen revealed that high ED values occurred exclusively in the tumor area with high cellularity. This study indicates that ED maps produced using DECT may have potential utility in the accurate identification of metastases with high cellularity in bone lesions.

Keywords: Bone biopsy; Bone metastasis; Computed tomography-guided intervention; Dual energy computed tomography; Electron density.

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Figures

Fig 1
Fig. 1
Images of the patient's right ilium. (a) An 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) image. The maximum standardized uptake value was 15.3. The patient's blood sugar at the time of imaging was 106 mg/dL. (b) A CT image to reveal bone condition. (c) Calcium suppression image (a virtual non-calcium technique). (d) Electron density map. The high cellularity region showed high electron density (white arrowhead). (e) A CT-guided bone biopsy image.
Fig 2
Fig. 2
A pathological specimen and electron density spectrum A substantial level of cancerous foci growth in bone tissue was observed, which was consistent with metastatic breast cancer. The high cellularity area occurred between the normal bone marrow and a low cellularity area with fibrosis. Electron density is maximal in the cortical bone area (7.02 × 1023/cm2) and lower in the areas surrounding the high cellularity region (4.47 × 1023/cm2).
See this image and copyright information in PMC

References

    1. Espinosa L.A., Jamadar D.A., Jacobson J.A., DeMaeseneer M.O., Ebrahim F.S., Sabb B.J. CT-guided biopsy of bone: a radiologist's perspective. AJR Am J Roentgenol. 2008;190(5):W283–W289. - PubMed
    1. Monfardini L., Preda L., Aurilio G., Rizzo S., Bagnardi V., Renne G. CT-guided bone biopsy in cancer patients with suspected bone metastases: retrospective review of 308 procedures. Radiol Med. 2014;119(11):852–860. - PubMed
    1. Yamamoto S., Matsumoto T., Suda S., Tomita K., Kamei S., Hashida K. First experience of efficacy and radiation exposure in 320-detector row CT fluoroscopy-guided interventions. British J Radiol. 2021;94(1120) - PMC - PubMed
    1. McCollough C.H., Leng S., Yu L., Fletcher J.G. Dual- and multi-energy CT: principles, technical approaches, and clinical applications. Radiology. 2015;276(3):637–653. - PMC - PubMed
    1. Johnson T.R. Dual-energy CT: general principles. AJR Am J Roentgenol. 2012;199(5 Suppl):S3–S8. - PubMed

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