ASSESSMENT OF SUSPECTED BONE METASTASES - CT WITH AND WITHOUT CLINICAL INFORMATION COMPARED TO CT-GUIDED BONE-BIOPSY

Purpose: To evaluate the role of CT with and without clinical informat ion as compared to CT-guided bone biopsy in the assessment of suspecte d bone metastases. Material and Methods: The study comprised 51 consec utive patients with suspected bone metastases who had undergone CT-gui ded bone biopsies with an eccentric drill system. CT of the targets, c linical information, and histopathology were scored separately as mali gnant, uncertain or benign. The results of CT alone and CT in combinat ion with clinical information were compared to the results of histopat hology. Results: Histopathology diagnosed 45/51 lesions (88%), 23 as m alignant and 22 as benign. CT correctly depicted 17 of these 23 malign ant lesions. The remaining 6 malignant lesions were: CT-scored as unce rtain (n=5) or benign (n=1). CT correctly depicted only 3 of the 22 be nign lesions. The remaining 19 benign lesions were CT-scored as malign ant (n=2) or uncertain (n=17). When uncertain CT scores were combined with clinical scores, the true-positive and true-negative results for malignancy increased from 44% to 82%. Conclusion: In most cases, CT in combination with clinical information gives enough information about the nature - malignant or benign - of a skeletal lesion. In uncertain cases, diagnostic accuracy can be improved by means of CT-guided bone biopsy.