Sonali Lala MD, Presenter: Nothing to Disclose

Netanel Berko MD, Abstract Co-Author: Nothing to Disclose

Karen Ellen Sperling MD, Abstract Co-Author: Nothing to Disclose

Alan H. Schoenfeld MS, Abstract Co-Author: Nothing to Disclose

Esperanza Villanueva-Siles MD, Abstract Co-Author: Nothing to Disclose

Nogah Haramati MD, Abstract Co-Author: Investor, Kryon Systems Ltd Investor, OrthoSpace Ltd Investor, BioProtect Ltd Board Member, Kryon Systems Ltd Board Member, OrthoSpace Ltd Board Member, BioProtect Ltd Consultant, AFC Industries, Inc Advisory Board, General Electric Company

Beverly A. Thornhill MD, Abstract Co-Author: Nothing to Disclose

Shlomit Goldberg-Stein MD, Abstract Co-Author: Research Consultant, Intrinsic Therapeutics Inc

CT-guided bone marrow biopsy and aspiration is conventionally performed using a manual needle, requiring physical pressure and rotation. We report our experience using a novel battery-powered rotatory bone drill in comparison with our prior use of a manual needle. 

After IRB approval, 20 CT-guided bone marrow aspiration and biopsy procedures were retrospectively reviewed. Ten were performed with a 13 Gauge manual needle and ten were performed with an 11 Gauge battery-powered bone drill. Patient demographics, procedure time, number of CT scans, and core sample size were recorded. Estimated radiation dose was calculated for each procedure by a physicist blinded to needle type. A blinded pathologist reviewed pathology reports and rated core samples as diagnostic/optimal, diagnostic/suboptimal, or non-diagnostic in consideration of overall quality and crush artifact. Median values and interquartile ranges (25th and 75th percentile) were calculated. Statistical analysis was performed using Fisher’s Exact test and Mann-Whitney U Test. 

No evidence for significant difference was found between the manual needle and drill groups with respect to patient age, gender, procedure time, number of scans, or estimated radiation dose. Estimated radiation dose (total DLP in mGy-cm) was 638.36 (430.18, 812.75) for the manual group and 529.56 (306.39, 754.74) for the drill group. Four of 10 manual group cores (40%) were of diagnostic/optimal quality, compared to 10/10 drill group cores (100%, p= 0.01). There were significantly more diagnostic/suboptimal (n=4) or non-diagnostic (n=2) cores in the manual group (6/10) compared to the drill group (0/10, p= 0.01). Median core length was 0.7 cm (0.38, 0.95) for manual group and 1.4 cm (1.30, 1.65) for drill group. Drill group cores were significantly longer than manual group cores (p<0.03).

Use of a battery-powered drill for CT-guided bone marrow biopsy provided significantly longer core biopsy samples (p<0.03) and significantly more optimal quality core samples (p=0.01) when compared to use of a manual needle, without increasing procedure time or radiation dose.

Bone marrow biopsy cores obtained using a powered drill are significantly longer and more often of optimal quality, when compared to cores obtained using a manual needle approach. This is the first report of outcomes using a drill for CT-guided bone marrow biopsy and aspiration.  

Lala, S, Berko, N, Sperling, K, Schoenfeld, A, Villanueva-Siles, E, Haramati, N, Thornhill, B, Goldberg-Stein, S, Manual Needle Versus Powered Drill for CT- Guided Bone Marrow Aspiration and Biopsy: A Comparison of Diagnostic Utility.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14009619.html