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Conference Proceeding - Restricted Access

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Purpose: In patients with multiple suspicious osseous lesions in the setting of a known primary malignancy, we sought to determine the rate at which tissue sampling of these osseous lesions yielded a different diagnosis from the primary malignancy. Secondary objective included determination of the complication rate in these biopsy procedures, including the need for re‐biopsy. Materials and Methods: Medical records for patients undergoing CT guided biopsy of a suspicious osseous lesion were retrospectively reviewed over a 12 month period from 2017 to 2018. There were 78 patients that underwent CT guided biopsy. Inclusion criteria for this study included: known primary cancer diagnosis, greater than three suspicious osseous lesion, and targeted CT guided biopsy performed by a musculoskeletal radiologist. The results of the biopsy lesions were then categorized as matched pathologic diagnosis, alternate pathologic diagnosis, no evidence of malignancy, and non‐diagnostic or unsatisfactory sample. Results: There were a total of 34 out of 80 CT guided biopsies that met the inclusion criteria. Of those included, 74% (n= 25) had matched pathologic diagnosis, 9% (n= 3) had an alternative pathologic diagnosis, 9% (n= 3) had no evidence of malignancy, and 9% (n= 3) had a non‐diagnostic or unsatisfactory sample. Alternative diagnosis included: breast cancer with different receptor profile, bone island, and adenocarcinoma unspecified. Of the 34 bone biopsies, no immediate post‐procedural complications were identified, and 3% required a re‐biopsy (n= 1). Conclusion: In patients with known primary malignancy and multiple suspicious osseous lesions, CT‐guided biopsy of a suspicious osseous lesion represented matched pathologic diagnosis of the primary malignancy in 74% of cases. An alternative diagnosis was obtained in 9% of cases, and there was no evidence of malignancy in 9% of cases. Our results suggest that given the rate of alternative pathologic diagnosis in this patient population, careful consideration should be made when determining the need for biopsy.


Society of Skeletal Radiology 42nd Annual Meeting, March 10-13, 2019. Scottsdale, AZ. Poster.