CT-guided biopsy of focal lesions in patients with multiple myeloma may reveal new and more aggressive cytogenetic abnormalities

BACKGROUND AND PURPOSE: Cytogenetic abnormalities, especially chromosome 13 deletion, are high-risk factors for multiple myeloma. Attaining the highes t detection rates of cytogenetic abnormalities is important to provide accu rate prognostic information to the referring oncologist. The purpose of thi s study was to use CT-guided percutaneous fine-needle aspiration bone biops y (CT-guided FNA) of MR-detected focal lesions in patients with multiple my eloma to increase identification of abnormal cytogenetics, METHODS: Patients enrolled in two clinical trials for myeloma therapy under went MR imaging of the entire spine and pelvis. CT-guided FNA biopsy sample s obtained from MR-detected focal lesions in these patients were sent for c ytogenetic analysis. FNA results were then compared with random bone marrow sampling of the iliac crest done at or near the same time as the FNA to pr ovide the data revealed in this study. RESULTS: Forty-one patients (47 lesions) in one of the trials and 37 patien ts (38 lesions) in the other trial had biopsies performed. CT-guided FNA re vealed cytogenetic abnormalities in 21% of the total patient population and new information in nearly 10% of the patients in one trial and in 20% of t hose in the other trial. CONCLUSION: CT-guided biopsy of MR-detected focal lesions is a safe techniq ue that can provide important cytogenetic information in a significant numb er of patients with multiple myeloma not identified during random marrow sa mpling.