Monfardini Lorenzo, Preda Lorenzo, Aurilio Gaetano, Rizzo Stefania, Bagnardi Vincenzo, Renne Giuseppe, Maccagnoni Sara, Vigna Paolo Della, Davide Disalvatore, Bellomi Massimo
Department of Radiology Milan, European Institute of Oncology, Via Ripamonti 435, 20100, Milan, Italy,
Radiol Med. 2014 Nov;119(11):852-60. doi: 10.1007/s11547-014-0401-4. Epub 2014 Apr 4.
The authors assessed the adequacy and sensitivity of CT-guided bone biopsy in 308 procedures performed in 286 cancer patients with suspected bone metastases.
An electronic search of our CT-guided bone biopsy database was retrospectively performed to evaluate the adequacy of samples and, in the event of negative samples, whether the patients had radiological progression at the site of biopsy (false negative). Adequacy and false-negative rate were compared with radiological features, biopsy location, specimen length and complications to assess any statistically relevant association with a multivariate logistic regression model.
A total of 290/308 (94.1 %) samples were adequate. Forty-five patients had normal bone marrow and were followed-up, with evidence of progression at the site of biopsy in 10 cases (false-negative cases); overall sensitivity was 96.7 %. Specimen length was significantly correlated to the probability of an adequate biopsy (p = 0.035) and inversely correlated to the probability to obtain a false-negative result (p = 0.02). We encountered 11/308 (3.5 %) minor complications and no major complications.
CT-guided biopsy of bone lesions in cancer patients allows for a final diagnosis in 94 % of cases. A specimen longer than 1 cm may lead to a significant result in terms of adequacy and sensitivity. Negative biopsies with positive positron emission tomography or magnetic resonance imaging and specimen shorter than 1 cm should be repeated to avoid a false-negative result.
作者评估了在286例疑似骨转移的癌症患者中进行的308例CT引导下骨活检的充分性和敏感性。
对我们的CT引导下骨活检数据库进行电子检索，以回顾性评估样本的充分性，以及在样本为阴性的情况下，患者在活检部位是否有影像学进展（假阴性）。将充分性和假阴性率与影像学特征、活检部位、标本长度和并发症进行比较，以评估与多变量逻辑回归模型的任何统计学相关关联。
总共290/308（94.1%）个样本是充分的。45例患者骨髓正常并接受随访，其中10例在活检部位有进展证据（假阴性病例）；总体敏感性为96.7%。标本长度与充分活检的概率显著相关（p = 0.035），与获得假阴性结果的概率呈负相关（p = 0.02）。我们遇到11/308（3.5%）例轻微并发症，无严重并发症。
癌症患者骨病变的CT引导活检在94%的病例中可实现最终诊断。长度超过1 cm的标本在充分性和敏感性方面可能会得出显著结果。对于正电子发射断层扫描或磁共振成像呈阳性但活检为阴性且标本短于1 cm的情况，应重复活检以避免假阴性结果。
