CT-GUIDED BONE-BIOPSY IN A CANCER CENTER - EXPERIENCE WITH A NEW APPLE CORER-SHAPED DEVICE

In this article we report our experience with CT-guided bone biopsy (C TGBB) using a new nondisposable bone biopsy device with in a uniform p rotocol for all lesions and compare our results with data from bone bi opsies obtained with other techniques. With this biopsy device, the sp ecimen is collected in a 20 x 2 mm chamber of an apple corer-shaped ne edle. In 46 consecutive cancer patients that were candidates for bone biopsy, 50 CTGBB procedures were performed and analyzed. Lesions with cortical defects and/or surrounding soft tissue infiltration were excl uded. There were no complications. Of 50 CTGBB procedures, 90% were di agnostic. Four of the five inconclusive biopsies were repeated: All we re conclusive, one malignant. Of 19 with CT-indistinguishable lesions (detected on MRI or isotope studies), 35% were malignant. Thirty-eight percent of the lesions were not accompanied by pain. The procedure wa s less painful than injection of the local anesthetic prior to biopsy in 90% of the cases. With the new device, CTGBB procedures can be carr ied out safely. Biopsy with the described technique has a high diagnos tic output, better results than those of biopsy with reported uniform techniques, and equal results to the best results of combined techniqu es. If a lesion is not distinguishable on CT and/or not accompanied by pain, malignancy is not ruled out. CTGBB in the described technique i s less or equally time consuming, less painful, and cheaper than repor ted for other bone biopsy procedures.