CT-guided biopsy of bone and soft-tissue lesions: Role of on-site immediate cytologic evaluation

Warapat Virayavanich, Michael D. Ringler, Cynthia T. Chin, Thomas Baum, Joseph C. Giaconi, Richard J. O'Donnell, Andrew E. Horvai, Kirk D. Jones, Thomas M. Link

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Purpose: To assess the impact of on-site immediate cytologic assessment (ICA) on the diagnostic success rate of computed tomography (CT)guided percutaneous needle biopsy (PNB) of musculoskeletal lesions and the long-term outcome in inconclusive PNB findings. Materials and Methods: A total of 299 CT-guided PNBs of musculoskeletal lesions performed between January 1997 and December 2009 were retrospectively reviewed. The lesions were categorized by their morphology, location, and size, and by biopsy type. The diagnostic success rates, impact of ICA, and outcome in inconclusive PNBs were studied, with final histopathologic findings and/or clinical follow-up as a reference. Results: The overall diagnostic success rate of PNBs was 72.9% (218 of 299). The success rate increased with larger lesions (> 2 cm to 4 cm; P = .009). Biopsies performed with ICA had a higher success rate (77.0% vs 63.3%; P = .015). PNBs had inconclusive results in 109 of 299 cases (36.5%). In 66 of these, repeat open biopsy or clinical follow-up demonstrated 19 malignant/aggressive lesions (28.8%) and 47 benign/nonaggressive lesions (71.2%). Conclusions: CT-guided PNB had a satisfactory success rate, which significantly increased when performed with ICA. Inconclusive results in PNB were most frequently associated with benign findings during further workup.

Original languageEnglish
Pages (from-to)1024-1030
Number of pages7
JournalJournal of Vascular and Interventional Radiology
Issue number7
StatePublished - Jul 2011
Externally publishedYes


  • CNB
  • FNA
  • ICA
  • PNB
  • core needle biopsy
  • fine-needle aspiration
  • immediate cytologic assessment
  • percutaneous needle biopsy


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