scholarly journals Percutaneous CT Guided Vertebral Biopsy: Anatomy and Technical Considerations

2021 ◽  
Author(s):  
Kunal Bharat Gala ◽  
Nitin S. Shetty ◽  
Amit Kumar Janu ◽  
Neeraj Shetty ◽  
Suyash S. Kulkarni
Keyword(s):  
Age Groups ◽  
Percutaneous Biopsy ◽  
Histopathological Analysis ◽  
Histopathological Diagnosis ◽  
Microbiological Analysis ◽  
Ct Guided ◽  
Image Guided ◽  
Multiple Cores ◽  
Ct Guided Biopsy ◽  
Vertebral Biopsy

AbstractIn this review article, the authors discuss the anatomy and technical aspects of CT-guided biopsy of vertebral lesions. CT guidance is highly useful for vertebral biopsies, as the anatomy of the spine is complex and varies widely across the levels. Prebiopsy imaging should be reviewed and later correlated with the final histopathological diagnosis. The majority of the spine biopsies are performed under local anesthesia, except those in critical locations and pediatric age groups. The biopsy sample is sent for histopathological analysis and/or microbiological analysis depending on the indications. It is preferable to use a coaxial system for biopsies, so multiple cores can be obtained with a single needle puncture, thus minimizing the negative yield and complications. Complications after image-guided percutaneous biopsy are rare and can be managed easily.

scholarly journals Percutaneous C-Arm Free O-Arm Navigated Biopsy for Spinal Pathologies: A Technical Note

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 636
Author(s):  
Masato Tanaka ◽  
Sumeet Sonawane ◽  
Koji Uotani ◽  
Yoshihiro Fujiwara ◽  
Kittipong Sessumpun ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Correct Diagnosis ◽  
Standard Technique ◽  
Percutaneous Biopsy ◽  
Technical Note ◽  
Spinal Tumors ◽  
Histopathological Diagnosis ◽  
Ct Guided ◽  
Ct Guided Biopsy ◽  
The Right

Background: Percutaneous biopsy under computed tomography (CT) guidance is a standard technique to obtain a definitive diagnosis when spinal tumors, metastases or infections are suspected. However, specimens obtained using a needle are sometimes inadequate for correct diagnosis. This report describes a unique biopsy technique which is C-arm free O-arm navigated using microforceps. This has not been previously described as a biopsy procedure. Case description: A 74-year-old man with T1 vertebra pathology was referred to our hospital with muscle weakness of the right hand, clumsiness and cervicothoracic pain. CT-guided biopsy was performed, but histopathological diagnosis could not be obtained due to insufficient tissue. The patient then underwent biopsy under O-arm navigation, so we could obtain sufficient tissue and small cell carcinoma was diagnosed on histopathological examination. A patient later received chemotherapy and radiation. Conclusions: C-arm free O-arm navigated biopsy is an effective technique for obtaining sufficient material from spine pathologies. Tissue from an exact pathological site can be obtained with 3-D images. This new O-arm navigation biopsy may provide an alternative to repeat CT-guided or open biopsy.

scholarly journals Percutaneous CT-Guided Biopsy of the Craniovertebral Junction: Safety, Diagnostic Yield, and Technical Notes

Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 168
Author(s):  
Paolo Spinnato ◽  
Eugenio Rimondi ◽  
Giancarlo Facchini
Keyword(s):  
Diagnostic Yield ◽  
Percutaneous Biopsy ◽  
Craniovertebral Junction ◽  
Vital Statistics ◽  
Bone Lesions ◽  
Histopathological Diagnosis ◽  
Ct Guided ◽  
Guided Biopsy ◽  
Ct Guided Biopsy ◽  
Prostate Cancers

The craniovertebral junction defined as the occiput, the atlas, and the axis is a complex bony region that contains vital neural and vascular structures. We report the experience of a single academic institution regarding CT-guided biopsy of this skeletal region. We reviewed all of the CT-guided biopsies performed in our department, completed in the craniovertebral junction. We collected data in regard to biopsy procedures, patients’ vital statistics, and histopathological diagnosis. In total, 16 patients (8M and 8F; mean age 52; range 16–86 years old) were included in this series. In eight patients, the lesions were located in the atlas vertebra (8/16—50%), in six patients in the axis (37.5%), and in two patients in the occiput (12.5%). No complications were observed during or after the procedures. All of the procedures were technically successful. The biopsy was diagnostic in 13/16 patients (81.3%): four metastatic lesions (25%—three breast and one prostate cancers), four multiple myeloma bone lesions (25%), three aneurismal bone cysts (18.8%), one aggressive hemangioma (6.3%), and one pseudogout (6.3%). Moreover, in two-thirds (66.6%) of non-diagnostic histological reports, malignancies were excluded. CT-guided percutaneous biopsy is a safe tool and allows obtaining a histological diagnosis, in most cases, even in the most delicate site of the human skeleton—the craniovertebral junction.

scholarly journals Concordance of PD-L1 Status Between Image-Guided Percutaneous Biopsies and Matched Surgical Specimen in Non-Small Cell Lung Cancer

2021 ◽  
Vol 10 ◽  
Author(s):  
Liang Zhao ◽  
Peiqiong Chen ◽  
Kaili Fu ◽  
Jinluan Li ◽  
Yaqing Dai ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Ct Guided ◽  
Tissue Sections ◽  
Image Guided ◽  
Guided Biopsy ◽  
Pet Ct ◽  
Ct Guided Biopsy ◽  
Lung Biopsies

ObjectiveProgrammed death-ligand 1 (PD-L1) expression status is a crucial index for identifying patients who will benefit from anti-programmed cell death protein 1 (PD-1)/PD-L1 therapy for non-small cell lung cancer (NSCLC). However, the concordance of Tumor Proportion Score (TPS) between biopsies and matched surgical specimens remains controversial. This study aims to evaluate the concordance of PD-L1 expression between image-guided percutaneous biopsies and matched surgical specimens.MethodWe evaluated 157 patients diagnosed with operable NSCLC on both surgical tissue sections and matched lung biopsies retrospectively. The patients underwent either regular computed tomography (CT)-guided biopsy (n = 82) or positron emission tomography (PET)/CT-guided biopsy (n = 75). The concordance between surgical specimens and lung biopsies for PD-L1 TPS was evaluated using Cohen’s kappa (κ) coefficient.ResultsImmunohistochemical expression of PD-L1 was evaluated in both surgical resected specimens and matched biopsies in the eligible 138 patients. The concordance rate of PD-L1 expression between surgical tissue sections and matched biopsies was fairly high at 84.1% (116/138), and the κ value was 0.73 (95% CI: 0.63–0.83, P < 0.001). The concordance rate was higher for tissue sections from PET/CT-guided biopsy than for tissue sections from CT-guided biopsy [88.6% (62/70, κ value: 0.81) vs 79.4% (54/68, κ value: 0.66)].ConclusionPD-L1 TPS was strongly concordant between surgical specimens and matched lung biopsies. Thus, the routine evaluation of PD-L1 expression in diagnostic percutaneous biopsies could be reliable for identifying patients who will benefit from anti-PD-1/PD-L1 immunotherapy.

Diagnostic yield and safety of percutaneous CT-guided biopsy of retroperitoneal lesions and analysis of imaging features

2021 ◽  
pp. 028418512199028
Author(s):  
Anil Kumar Singh ◽  
Zafar Neyaz ◽  
Ritu Verma ◽  
Anshul Gupta ◽  
Richa Mishra ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Final Diagnosis ◽  
Microbiological Analysis ◽  
Imaging Features ◽  
Imaging Findings ◽  
Chi Square ◽  
Tissue Samples ◽  
Ct Guided ◽  
Guided Biopsy ◽  
Ct Guided Biopsy

Background Computed tomography (CT)-guided biopsy is emerging as a preferred method for obtaining tissue samples from retroperitoneal lesions due to clear visualization of needle and vessels. Purpose To assess diagnostic yield and safety of CT-guided biopsy of retroperitoneal lesions and compare CT findings in different disease categories. Material and Methods This retrospective analytical study included 86 patients with retroperitoneal lesions who underwent CT-guided biopsy from December 2010 to March 2020. All procedures were performed with co-axial technique and multiple cores were obtained and subjected to histopathology. Additional tests like immunohistochemistry or microbiological analysis were done depending on clinical suspicion. Diagnostic yield calculation and comparison of imaging findings was done by one-way ANOVA, chi-square, and Fisher’s exact tests. Results CT-guided biopsy was technically successful in all cases with a diagnostic yield of 91.9%. Minor complications in the form of small hematomas were seen in two patients. Major disease categories on final diagnosis were lymphoma, tuberculosis, and metastases. A variety of malignant and benign soft-tissue neoplasms were also noted less commonly. With help of immunohistochemistry, lymphoma subtype was established in 88.8% of cases. Addition of microbiological tests like the GeneXpert assay helped in the diagnosis of tuberculosis in some cases. A mass-like appearance and vascular encasement was common in metastatic group and lymphoma. Conclusion Percutaneous CT-guided biopsy is a safe method for the sampling of retroperitoneal lesions with high diagnostic yield. Imaging findings are mostly overlapping; however, some features are more common in a particular disease condition.

Comparative study between image-guided percutaneous biopsies and matched surgical specimens for the evaluation of PD-L1 status in non-small cell lung cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e15168-e15168
Author(s):  
Liang Zhao ◽  
Haojun Chen ◽  
Kaili Fu ◽  
Yanzhen Zhuang ◽  
Qin Lin
Keyword(s):  
Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Ct Guided ◽  
Tissue Sections ◽  
Image Guided ◽  
Guided Biopsy ◽  
Pet Ct ◽  
Ct Guided Biopsy ◽  
Lung Biopsies

e15168 Background: Programmed death-ligand 1 (PD-L1) expression status is a crucial index for identifying patients who will benefit from anti-programmed cell death protein 1 (PD-1)/PD-L1 therapy for non-small cell lung cancer (NSCLC). However, the concordance of Tumor Proportion Score (TPS)between biopsies and matched surgical specimens remains controversial. This study aimed to evaluate the concordance of PD-L1 expression between image-guided percutaneous biopsies and matched surgical specimens. Methods: We evaluated 157 patients diagnosed with operable NSCLC on both surgical tissue sections and matched lung biopsies. The patients underwent either regular computed tomography (CT)-guided biopsy (n = 82) or positron emission tomography (PET)/CT-guided biopsy (n = 75). The concordance between surgical specimens and lung biopsies for PD-L1 TPS was evaluated using Cohen’s kappa (κ) coefficient. Results: Immunohistochemical expression of PD-L1 was evaluated in both surgical resected specimens and matched biopsies in the eligible 138 patients. The concordance rate of PD-L1 expression between surgical tissue sections and matched biopsies was fairly high at 83.3% (115/138), and the κ value was 0.73 (95% CI: 0.63–0.83, P < 0.001). The concordance rate was higher for tissue sections from PET/CT-guided biopsy than for tissue sections from CT-guided biopsy (88.6% [62/70, κ value: 0.81] vs 77.9% [53/68, κ value: 0.66]). Conclusions: PD-L1 TPS was strongly concordant between surgical specimens and matched lung biopsies. Thus, routine evaluation of PD-L1 expression in diagnostic percutaneous biopsies could be reliable for identifying patients who will benefit from anti-PD-1/PD-L1 immunotherapy. [Table: see text]

scholarly journals AB0942 INFECTIOUS SPONDYLODISCITIS: TUBERCULOSIS VERSUS BRUCELLOSIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1770.1-1770
Author(s):  
R. Grassa ◽  
J. Anoun ◽  
M. Thabet ◽  
D. E. H. Abid ◽  
F. Ben Fredj ◽  
...  
Keyword(s):  
Group Versus ◽  
Spinal Pain ◽  
Neurological Complications ◽  
Ct Guided ◽  
Medicine Department ◽  
Ct Guided Biopsy ◽  
Infectious Spondylodiscitis ◽  
Vertebral Biopsy ◽  
Inflammatory Syndrome

Background:Infectious spondylodiscitis is a serious impairment that can compromise the functional and vital prognosis. The determination of the germ responsible is the key of the treatment.Objectives:The objective of our work is to describe the epidemiological, clinical and evolutionary profile according to the germ responsible by comparing tuberculous and brucellar spondylodiscitis.Methods:This is a retrospective study including 32 cases of spondylodiscitis with specific germs (Mycobacterium tuberculosis and Brucella) collected in an internal medicine department over a period of 18 years (2000-2018).Results:These were 20 men and 12 women with an M / F ratio of 1.66. The average age of our patients was 50.63 [16-84]. The germ implicated was Koch’s Bacillus in 11 patients (34.38%) and Brucella in 21 patients (65.63%). The mean age for tuberculosis (TB) was 45.18 years versus 53.48 years for brucellosis. Spinal pain was the major symptom in the 02 groups. The deterioration in general condition was present in 80.95% for the brucellosis group versus 81.82% for the tuberculosis group.Biological inflammatory syndrome was observed in 94.24% of the brucellosis group and 63.63% of the TBC group. The lumbar location was the most frequent in the 02 groups (71.88%).It was a multifocal localization in 27.27% (TB) and 61.90% (Brucellosis) respectively. The imaging allowed the detection of para abscesses -vertebral in 54.55% for the TB group versus 23.81% for the brucellar group. An epiduritis was objectified in 36.36% of the TB group against 33.33% for that of brucellar. CT-guided biopsy was performed in 54.55% of tuberculosis patients compared to 47.62% in the other group. It was only positive in one case of brucellosis, whereas it allowed diagnosis in 36.36% of cases of TB.The evolution after initiation of adequate antibiotic treatment was interspersed with neurological complications in the tuberculosis group in 18.18% of cases against 14.29% in the brucellosis group. Draining abscess was necessary in the tuberculosis group in 18.18% and in 9.52% of the brucellosis cases.Conclusion:Our results show a higher frequency of neurological complications in tuberculosis forms. Vertebral biopsy is of no interest in Brucellar spondylodiscitis unlike tuberculosis forms where it allows the diagnosis.References:[1]Bousson,et al (2014). Infection rachidienne: du germe lent au staphylocoque doré. Revue Du Rhumatisme Monographies, 81(1), 27–35.[2]Bierry, G., & Dietemann, J.-L. (2012). Imagerie des spondylodiscites infectieuses. EMC - Radiologie et Imagerie Médicale - Musculosquelettique - Neurologique - Maxillofaciale, 7(4), 1–16.Disclosure of Interests:None declared

Multiple paraspinal intramuscular myxomas: case report

2020 ◽  
Vol 32 (4) ◽  
pp. 519-522
Author(s):  
Joseph S. Domino ◽  
Shane Weindel ◽  
Sarah Woodrow
Keyword(s):  
Surgical Excision ◽  
Mass Effect ◽  
Carney Complex ◽  
Growth Patterns ◽  
Benign Tumors ◽  
Histopathological Analysis ◽  
Genetic Syndromes ◽  
Ct Guided ◽  
Genetic Syndrome ◽  
Ct Guided Biopsy

Intramuscular myxomas (IMMs) are rare benign tumors of mesenchymal origin that are most often located in large skeletal muscles, particularly of the thigh. They have also been reported within the paraspinal musculature and should be considered in the differential diagnosis of a paraspinal mass. These lesions can cause neurological symptoms due to mass effect. This is a report of a 52-year-old man with multiple paraspinal tumors that exhibited concerning growth on serial imaging studies. To the authors’ knowledge, this represents the first report of a patient with multiple paraspinal myxomas. CT-guided biopsy followed by surgical excision of the largest mass was performed. Histopathological analysis was consistent with an IMM. Patients with multiple IMMs often have an underlying genetic syndrome such as Mazabraud syndrome, McCune-Albright syndrome, or Carney complex. Despite variable growth patterns and associations with genetic syndromes, multiple IMMs have had no documented cases of malignant transformation into myxoid sarcoma; therefore, surgical excision should be considered based on a patient’s individual symptoms.

scholarly journals Computed tomography-guided bone lesion biopsy, our experience in 2018 and 2019

2020 ◽  
Vol 48 (2-3) ◽  
pp. 73-76
Author(s):  
Elvira Krešić ◽  
◽  
Ana-Marija Alduk ◽  
Maja Prutki ◽  
Ivan Karlak ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Histological Analysis ◽  
Bone Lesion ◽  
Bone Lesions ◽  
Histopathological Analysis ◽  
Ct Guided ◽  
Metastatic Lesions ◽  
Ct Guided Biopsy ◽  
Procedural Complications ◽  
Histopathological Results

To present our results from 2018 and 2019 and to present the clinical data of the accuracy and clinical usefulness of computed tomography (CT)-guided biopsy for diagnosing suspicious bone lesion. The retrospective study included 98 consecutive patients who underwent CT-guided bone lesion biopsy from January 2018 to December 2019. The localization of the bone lesions, the adequacy of the sample for histopathological analysis, histopathological results, and the procedure’s complications were analyzed. The specimens collected from 76 patients/lesions (77.6%) were considered appropriate for diagnosis. Histological analysis of bone samples showed 52 (68.4%) metastatic lesions. The most common primary tumor origins were breast carcinoma 28 (53.8%) and lung carcinoma six (11.5%). In three patients (4%), the infection was confirmed. No tumor cells were found in 17 (22.4%) patients. There were no post-procedural complications. CT-guided bone lesion biopsy is a safe and effective method for diagnosing suspicious bone lesions that has a great effect in clinical practice without any significant complications.

CT-guided core-needle biopsy in omental pathology

1997 ◽  
Vol 38 (6) ◽  
pp. 978-981 ◽  
Author(s):  
F. Pombo ◽  
E. Rodriguez ◽  
R. Martin ◽  
M. Lago
Keyword(s):  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Percutaneous Biopsy ◽  
Final Diagnosis ◽  
Endoscopic Biopsy ◽  
Ct Guided ◽  
Core Needle ◽  
Laparoscopic Biopsy ◽  
Ct Guided Biopsy ◽  
Sensitivity Specificity

Purpose: to assess the accuracy and clinical usefulness of CT-guided core-needle biopsy in the diagnosis of omental pathology Material and Methods: We retrospectively reviewed the results of CT-guided percutaneous core biopsies in 25 patients with focal (n=2) or diffuse (n=23) omental pathology. These results were compared to the final diagnoses as determined by laparotomy (n=15), laparoscopic biopsy (n=3), endoscopic biopsy (n=1), or by the results of percutaneous biopsy and clinical-radiological and bacteriological modalities (n=6). the final diagnoses showed 4 patients with isolated omental pathology and 21 with widespread peritoneal involvement. the CT-guided biopsies were performed with 1.0–1.8-mm Surecut core-needles Results: in 16 patients, the final diagnosis was metastatic adenocarcinoma - with the primary tumor sites in the ovary (n=3), stomach (n=1), appendix (n=2), and unknown (n=10). in the remaining 9 patients, the final diagnosis was hepatocellular carcinoma, lymphoma, and mesothelioma in 1 patient each; tuberculosis in 5; and actinomycosis in 1. Sufficient histological (n=16) or cytological (n=8) material was obtained by CT biopsy in 24/25 (96%) cases; the specimen was insufficient for diagnosis in 1 case. in differentiating benign from malignant disease, CT-guided biopsy showed a sensitivity, specificity and accuracy of respectively 89.5%, 100% and 92%. It gave a specific diagnosis in 78.9% (15/19) of patients with malignant conditions and in 50% (3/6) of patients with benign disorders. There were no biopsy-related complications Conclusion: CT-guided percutaneous core-needle biopsy of the omentum is a safe, useful and highly accurate procedure for diagnosing malignant omental pathology

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