Rounak R. Bafana MD, Presenter: Nothing to Disclose

Nick Ryan Reeser MD, Abstract Co-Author: Nothing to Disclose

Kevin McGill MD, MPH, Abstract Co-Author: Nothing to Disclose

Marnix T. van Holsbeeck MD, Abstract Co-Author: Consultant, General Electric Company Consultant, Koninklijke Philips NV Stockholder, Koninklijke Philips NV Stockholder, General Electric Company Grant, Siemens AG Grant, General Electric Company

To compare the diagnostic accuracy of ultrasound (US)-guided biopsy with computed tomography (CT)-guided biopsy, regarding primary and metastatic bone lesions.         

A retrospective review was performed on 116 patients presenting with lesions of the appendicular skeleton and shoulder girdle that were suspicious for primary or metastatic bone malignancy. All patients underwent percutaneous needle core biopsy and/or fine needle aspiration (FNA) using CT (n = 83 ) or ultrasound (n = 33) guidance. Samples obtained by CT and ultrasound were then stratified by lesion characteristics (size, radiographic features, location), biopsy type (core vs FNA), and categorized as either Group A - Diagnostic or Group B – non-diagnostic. Diagnostic accuracy was based on comparison to surgical pathology and clinical outcome.  

Overall accuracy of US-guided cases was 87.9% (29/33) whereas for CT-guided cases it was 87.9% (72/83). Biopsy results were further broken down by lesion size. For US, 88.9% of lesions 0-3cm were diagnostic, 85.7% of lesions 4-6cm were diagnostic, and 90% of lesions greater than 6cm were diagnostic. For CT, 80.0% of lesions 0-3cm were diagnostic, 92.9% of lesions 4-6cm were diagnostic and 81.3% of lesions greater than 6cm were diagnostic.  

Ultrasound and CT have comparable diagnostic accuracy in the sampling of bone lesions, regardless of size.  

With comparable accuracy to CT and the benefits of lower cost, lack of radiation, and the ability to perform procedures at bedside, ultrasound is an ideal method for clinicians to investigate suspicious osseous lesions.  

Bafana, R, Reeser, N, McGill, K, van Holsbeeck, M, Evaluating Bone Neoplasia: Ultrasound-guided Biopsy vs. Computed Tomography-guided Biopsy.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14011112.html