Department of Radiology, Aventura Hospital and Medical Center, 20900 Biscayne Blvd, Aventura, FL, 33180, USA.
Department of Radiology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
Skeletal Radiol. 2021 Apr;50(4):731-738. doi: 10.1007/s00256-020-03616-4. Epub 2020 Sep 23.
To determine the frequency of non-diagnostic and discordant results from bone and soft tissue biopsies performed at our institution over a 3-year period and to investigate whether implementation of a weekly musculoskeletal radiology-pathology correlation conference decreased the time to appropriate patient management in cases of discordance.
Consecutive image-guided core needle biopsy results obtained over a 12 month period of time were reviewed in a retrospective fashion. Following implementation of the correlation conference, subsequent consecutive image-guided core needle biopsy results obtained over a 26 month period of time were reviewed in a prospective fashion. For non-diagnostic and discordant cases, the time in days from date of availability of the biopsy result to date of documentation of a specific follow-up action plan was recorded.
Diagnostic yield was 96.5% and 94.9% for the retrospective and prospective periods, respectively. There were four discordant results in the retrospective cohort (1.7%) and seven discordant results in the prospective cohort (2.1%). Following implementation of the weekly correlation conference, there was significant decrease (p < 0.05) in median time from a discordant biopsy result to follow-up action plan. There were no unnecessary surgeries, litigation, or other unfavorable consequences in either cohort.
Image-guided core needle biopsies of bone and soft tissue provide high diagnostic yield, often with specific diagnoses. The statistically significant decrease in number of days to follow-up action plan for discordant results suggests radiology-pathology review has a positive impact on patient care. Subjective benefits from communication and educational standpoints are also noteworthy.
确定在我们机构进行的骨骼和软组织活检在 3 年期间出现非诊断和不一致结果的频率，并研究每周进行肌肉骨骼放射科-病理学相关性会议是否可以减少不一致病例中适当患者管理的时间。
回顾性分析了在 12 个月时间内获得的连续影像学引导下核心针活检结果。在相关性会议实施后，前瞻性地分析了在 26 个月时间内获得的随后连续影像学引导下核心针活检结果。对于非诊断和不一致的病例，从活检结果可用之日到记录特定随访行动计划之日的天数记录。
回顾性和前瞻性研究的诊断率分别为 96.5%和 94.9%。在回顾性队列中有 4 个不一致的结果（1.7%），在前瞻性队列中有 7 个不一致的结果（2.1%）。在每周进行相关性会议后，从不一致活检结果到随访行动计划的中位数时间显著缩短（p<0.05）。在两个队列中均未发生不必要的手术、诉讼或其他不利后果。
骨骼和软组织的影像学引导下核心针活检提供了高的诊断率，通常具有明确的诊断。不一致结果的随访行动计划天数的显著减少表明放射科-病理学审查对患者护理有积极影响。从沟通和教育的角度来看，主观上的获益也值得注意。
