Image-guided core needle biopsy for Ewing sarcoma of bone: a 10-year single-institution review
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MUSCULOSKELETAL
Image-guided core needle biopsy for Ewing sarcoma of bone: a 10-year single-institution review Sarah Kalus 1
&
Alessandro Vidoni 1 & Inês Oliveira 1 & Asif Saifuddin 1
Received: 14 November 2019 / Revised: 26 March 2020 / Accepted: 28 April 2020 # European Society of Radiology 2020
Abstract Objective To evaluate the performance of image-guided core needle biopsy (IGCNB) for the diagnosis of Ewing sarcoma of bone. Methods All patients with a confirmed diagnosis of Ewing sarcoma who underwent IGCNB between January 2007 and December 2016 were included in this retrospective study. Analysis included mean age, skeletal distribution, imaging modality used for biopsy guidance, type of anaesthesia, needle type, number of passes, type of tissue sampled, and complications. Results The study included 139 patients (94 males and 45 females; mean age 18.7 years) who underwent 141 image-guided core needle biopsies as the primary diagnostic test. Of these, 101 were CT-guided, 38 ultrasound-guided, and 2 utilised both CT and ultrasound guidance. A total of 97.9% were diagnostic at first procedure. Of the 3 non-diagnostic cases, 2 underwent a further IGCNB and were positive, while 1 patient required an open surgical procedure. Only 1 patient (0.7%) suffered an immediate complication, and there were no recorded delayed complications. Conclusion IGCNB is a safe procedure providing a positive diagnosis of Ewing sarcoma of bone in a very high percentage of cases. It should be the first-line method for establishing a diagnosis in suspected Ewing sarcoma of bone. Key Points • Image-guided core needle biopsy is a safe procedure providing a positive diagnosis of Ewing sarcoma of bone in a very high percentage of cases. • Image-guided core needle biopsy should be the first-line method for establishing a definitive diagnosis in Ewing sarcoma and should be performed at a specialist sarcoma referral centre. • When technically feasible, extra-osseous soft tissue alone can be sampled with confidence as there is no difference in diagnostic performance whether bone or an extra-osseous soft tissue component of the tumour is sampled. Keywords Sarcoma, Ewing . Image-guided biopsy . Musculoskeletal system . Bone neoplasms
Abbreviations ABC Aneurysmal bone cyst FNAC Fine needle aspiration cytology GA General anaesthesia IGCNB Image-guided core needle biopsy LA Local anaesthesia MDT Multidisciplinary team
* Sarah Kalus [email protected] 1
The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore HA7 4LP, UK
Introduction A variety of options are available for achieving a histological diagnosis of a suspected bone tumour, including fine needle aspiration cytology (FNAC), image-guided core needle biopsy (IGCNB), and surgical incisional biopsy [1, 2]. CT-guided core needle biopsy has a diagnostic accuracy that is not significantly inferior to incisional biopsy in a wide variety of bone and soft tissue tumours, while being associated with fewer complications [3], and a recent meta-analysis has supported the role of specialist
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