Objective: To determine the value of sonographically guided core needle biopsies of musculoskeletal tumors as a reliable alternative to fluoroscopy and computed tomography.
Methods: A prospective study was performed in 74 patients referred for image-guided needle biopsy of primary or recurrent musculoskeletal neoplasms and suspected solitary metastasis. Imaging studies performed before biopsy established the feasibility of sonographic guidance in 65 lesions, of which 38 were soft tissue tumors and 27 were bone lesions with extraosseous masses. The lesions were located mainly in the appendicular skeleton. Tissue samples were obtained with a 14-gauge cutting needle coupled to an automated biopsy device under local anesthesia and sonographic guidance. Statistical analysis was based on 48 biopsies confirmed by successful clinical treatment (10 cases) or surgical resection (38 cases).
Results: An accurate diagnosis was obtained in 47 (97%) of 48 biopsies; sensitivity was 96%, and specificity was 100%. The method did not yield sufficient tissue to establish a diagnosis in 1 case. Considering all 65 biopsies, high-quality specimens were obtained in 96%. The procedure was carried out expeditiously, and there were no complications.
Conclusions: Sonographically guided core needle biopsy is accurate and safe, obviating open biopsy in most soft tissue masses and bone tumors with extraosseous masses in the appendicular skeleton. In such patients, the sonographically guided procedure is the most prompt and effective method for obtaining tissue samples.