JOURNAL CLUB: CT-Guided Bone Biopsies With Indeterminate Results in Pediatric Patients

2018 ◽  
Vol 211 (3) ◽  
pp. 661-671 ◽  
Author(s):  
Ömer Kasalak ◽  
Jelle Overbosch ◽  
Albert J. H. Suurmeijer ◽  
Paul C. Jutte ◽  
Thomas C. Kwee
Keyword(s):  
Pediatric Patients ◽  
Journal Club ◽  
Ct Guided ◽  
Bone Biopsies

scholarly journals Differences in Radiation Exposure of CT-Guided Percutaneous Manual and Powered Drill Bone Biopsy

2021 ◽  
Author(s):  
Sebastian Zensen ◽  
Sumitha Selvaretnam ◽  
Marcel Opitz ◽  
Denise Bos ◽  
Johannes Haubold ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Diagnostic Yield ◽  
Bone Biopsy ◽  
Lumbar Vertebrae ◽  
Bone Lesions ◽  
Anatomical Location ◽  
Thoracic Vertebrae ◽  
Level Of Evidence ◽  
Ct Guided ◽  
Bone Biopsies

Abstract Purpose Apart from the commonly applied manual needle biopsy, CT-guided percutaneous biopsies of bone lesions can be performed with battery-powered drill biopsy systems. Due to assumably different radiation doses and procedural durations, the aim of this study is to examine radiation exposure and establish local diagnostic reference levels (DRLs) of CT-guided bone biopsies of different anatomical regions. Methods In this retrospective study, dose data of 187 patients who underwent CT-guided bone biopsy with a manual or powered drill biopsy system performed at one of three different multi-slice CT were analyzed. Between January 2012 and November 2019, a total of 27 femur (A), 74 ilium (B), 27 sacrum (C), 28 thoracic vertebrae (D) and 31 lumbar vertebrae (E) biopsies were included. Radiation exposure was reported for volume-weighted CT dose index (CTDIvol) and dose–length product (DLP). Results CTDIvol and DLP of manual versus powered drill biopsy were (median, IQR): A: 56.9(41.4–128.5)/66.7(37.6–76.2)mGy, 410(203–683)/303(128–403)mGy·cm, B: 83.5(62.1–128.5)/59.4(46.2–79.8)mGy, 489(322–472)/400(329–695)mGy·cm, C: 97.5(71.6–149.2)/63.1(49.1–83.7)mGy, 627(496–740)/404(316–515)mGy·cm, D: 67.0(40.3–86.6)/39.7(29.9–89.0)mGy, 392(267–596)/207(166–402)mGy·cm and E: 100.1(66.5–162.6)/62.5(48.0–90.0)mGy, 521(385–619)/315(240–452)mGy·cm. Radiation exposure with powered drill was significantly lower for ilium and sacrum, while procedural duration was not increased for any anatomical location. Local DRLs could be depicted as follows (CTDIvol/DLP): A: 91 mGy/522 mGy·cm, B: 90 mGy/530 mGy·cm, C: 116 mGy/740 mGy·cm, D: 87 mGy/578 mGy·cm and E: 115 mGy/546 mGy·cm. The diagnostic yield was 82.4% for manual and 89.4% for powered drill biopsies. Conclusion Use of powered drill bone biopsy systems for CT-guided percutaneous bone biopsies can significantly reduce the radiation burden compared to manual biopsy for specific anatomical locations such as ilium and sacrum and does not increase radiation dose or procedural duration for any of the investigated locations. Level of Evidence Level 3.

scholarly journals Detection of PIK3CA Mutations in Breast Cancer Bone Metastases

ISRN Oncology ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-8
Author(s):  
Manijeh Daneshmand ◽  
Jennifer E. L. Hanson ◽  
Mitra Nabavi ◽  
John F. Hilton ◽  
Lisa Vandermeer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Marrow ◽  
Bone Metastases ◽  
Cancer Cells ◽  
Primary Tumour ◽  
Breast Cancer Patients ◽  
Ct Guided ◽  
Mutation Status ◽  
Bone Biopsies ◽  
Metastatic Sites

Background. An important goal of personalized cancer therapy is to tailor specific therapies to the mutational profile of individual patients. However, whole genome sequencing studies have shown that the mutational profiles of cancers evolve over time and often differ between primary and metastatic sites. Activating point mutations in the PIK3CA gene are common in primary breast cancer tumors, but their presence in breast cancer bone metastases has not been assessed previously. Results. Fourteen patients with breast cancer bone metastases were biopsied by three methods: CT-guided bone biopsies; bone marrow trephine biopsies; and bone marrow aspiration. Samples that were positive for cancer cells were obtained from six patients. Three of these patients had detectable PIK3CA mutations in bone marrow cancer cells. Primary tumor samples were available for four of the six patients assessed for PIK3CA status in their bone metastases. For each of these, the PIK3CA mutation status was the same in the primary and metastatic sites. Conclusions. PIK3CA mutations occur frequently in breast cancer bone metastases. The PIK3CA mutation status in bone metastases samples appears to reflect the PIK3CA mutation status in the primary tumour. Breast cancer patients with bone metastases may be candidates for treatment with selective PIK3CA inhibitors.

Radiation dose associated with CT-guided drain placement for pediatric patients

2017 ◽  
Vol 47 (6) ◽  
pp. 718-723
Author(s):  
Cody J. Schwartz ◽  
Ari J. Isaacson ◽  
Lynn Ansley Fordham ◽  
Marija Ivanovic ◽  
J. Bradford Taylor ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Pediatric Patients ◽  
Ct Guided ◽  
Drain Placement

JOURNAL CLUB: Ultrasound for Differentiation Between Perforated and Nonperforated Appendicitis in Pediatric Patients

2013 ◽  
Vol 200 (5) ◽  
pp. 957-962 ◽  
Author(s):  
Einat Blumfield ◽  
Gopi Nayak ◽  
Ramya Srinivasan ◽  
Matthew Tadashi Muranaka ◽  
Netta M. Blitman ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Journal Club

scholarly journals CT-guided blood tattoo for thoracoscopic excision of lung lesions in pediatric patients

2020 ◽  
Vol 12 (8) ◽  
pp. 4284-4291
Author(s):  
Fariha Sheikh ◽  
Ryan J. Brandt ◽  
Michael J. Tsapakos ◽  
Reto M. Baertschiger ◽  
Daniel P. Croitoru
Keyword(s):  
Pediatric Patients ◽  
Ct Guided ◽  
Lung Lesions

scholarly journals CT–Guided Bone Biopsies in Metastatic Castration-Resistant Prostate Cancer: Factors Predictive of Maximum Tumor Yield

2017 ◽  
Vol 28 (8) ◽  
pp. 1073-1081.e1 ◽  
Author(s):  
Michael G. Holmes ◽  
Erik Foss ◽  
Gabby Joseph ◽  
Adam Foye ◽  
Brooke Beckett ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Castration Resistant Prostate Cancer ◽  
Ct Guided ◽  
Castration Resistant ◽  
Bone Biopsies ◽  
Tumor Yield

scholarly journals P044 Tibia honest, it takes a lot of spine to diagnose DISC

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Wan Lin Ng ◽  
Aqeel Anjum ◽  
Joe Devlin ◽  
Alexander Fraser
Keyword(s):  
Inflammatory Markers ◽  
Plasma Cells ◽  
Whole Body ◽  
Heroin Addiction ◽  
Dramatic Improvement ◽  
Diagnostic Dilemma ◽  
Male Adult ◽  
Ct Guided ◽  
Osteolytic Lesions ◽  
Bone Biopsies

Abstract Background/Aims  CRMO is a rare autoinflammatory condition characterised by sterile bone osteolytic lesions which is described mainly in children with a female preponderance. Methods  A 31 year-old male presented with a 4-week history of productive cough, abdominal pain, left sided chest pain and right hip pain. He is a smoker with a background of heroin addiction and alcohol abuse. He was homeless and no family history available as he was fostered. His chest radiography was unremarkable but he had inflammatory markers. He was treated for as chest infection and heroin withdrawal. CT abdomen and pelvis demonstrated multiple osteolytic lesions in the pelvis, sternum, thoracic and lumbar spine. His HIV, Quantiferon and blood cultures were negative. His immunoglobulins, urine Bence Jones protein and echocardiogram were normal. In-depth assessment by the Infectious Disease team failed to isolate an infective pathogen. Bone marrow aspirate and trephine were unremarkable. Two CT-guided bone biopsies done twice showed plasma cells and macrophages. His condition deteriorated rapidly over 2 months. He mobility was reduced to wheelchair-bound and had dramatic 10kg weight loss. Results  In the absence of an infective or malignant cause, the Rheumatology service was consulted. Having reviewed the extensive data available, he was diagnosed with a likely but unusually aggressive form of adult-onset chronic recurrent multifocal osteomyelitis (CRMO). He was commenced initially on IV methylprednisolone, zoledronic acid, methotrexate and, etoricoxib. Subsequently he was treated with, tocilizumab and teriparatide. Whole body MRI revealed numerous other lesions not evident on previous imaging including lesions of the distal right humerus, proximal right femur and both tibias. His symptoms and inflammatory markers improved substantially over several days following treatment. A repeat full body MRI demonstrated dramatic improvement in the bony lesions. Soon he was able to walk again and gained some weight before he absconded from the hospital. His treatment was changed to tocilizumab infusion and denosumab injection to facilitate compliance. Conclusion  This is an unusual fascinating case which posed a significant diagnostic dilemma. Ruling out infection particularly in great challenge in diagnosing CRMO in a male adult who is homeless and a heroin abuser presenting with multifocal osteolytic lesions was challenging. The severity of his condition necessitated using novel treatments such as tocilizumab. Disclosure  W. Ng: None. A. Anjum: None. J. Devlin: None. A. Fraser: None.

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