Concordance between fine-needle aspiration and core biopsies for osseous lesions by lesion imaging appearance and CT attenuation

John Li; Zoe Weissberg; Thomas A Bevilacqua; Gordon Yu; Kristy Weber; Ronnie Sebro

doi:10.1007/s11547-017-0841-8

Concordance between fine-needle aspiration and core biopsies for osseous lesions by lesion imaging appearance and CT attenuation

Radiol Med. 2018 Apr;123(4):254-259. doi: 10.1007/s11547-017-0841-8. Epub 2017 Dec 16.

Authors

John Li¹, Zoe Weissberg¹, Thomas A Bevilacqua¹, Gordon Yu², Kristy Weber³, Ronnie Sebro⁴

Affiliations

¹ Department of Radiology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
² Department of Pathology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
³ Department of Orthopedic Surgery, University of Pennsylvania, 3400 Civic Center Blvd, Perelman Center South Tower, Room 10-179, Philadelphia, PA, 19104, USA.
⁴ Department of Radiology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA. Ronnie.sebro@uphs.upenn.edu.

PMID: 29249078
DOI: 10.1007/s11547-017-0841-8

Abstract

Objectives: To compare the concordance between fine-needle aspiration and core biopsies for osseous lesions by lesion imaging appearance and CT attenuation.

Materials and methods: Retrospective review of 215 FNAs of osseous lesions performed in conjunction with core biopsy at our institution over a 6-year period (2011-2016). FNAs were interpreted independently of core biopsies. We assessed if FNA in conjunction with core biopsy increased diagnostic accuracy compared to core biopsy alone. We also calculated the concordance between FNA and core biopsy by lesion appearance, lesion CT attenuation, lesion histology, lesion location and FNA needle gauge size.

Results: Core biopsy alone provided the diagnosis in 207/215 cases (96.3%), however, the FNA provided the diagnosis in the remaining 8/215 cases (3.7%) where the core biopsy was non-diagnostic. There were 154 (71.6%) lytic lesions, 21 (9.8%) blastic lesions, 25 (11.6%) mixed lytic and blastic lesions and 15 (7.0%) lesions that were neither lytic nor blastic. The concordance between FNA and core biopsy for lytic osseous lesions (136/154 cases, 88.3%) was statistically significantly higher than that for blastic osseous lesions (13/21 cases, 61.9%) [P = 4.2 × 10^-3; 95% CI (0.02, 0.50)]. The concordance between FNA and core biopsy was higher for low-attenuation- (110/126) than high-attenuation (58/77) lesions (P = 0.028). The concordance between FNA and core biopsy was also higher for metastases (102/119 cases, 85.7%) than non-metastases (78/96, 81.3%) [P = 0.487; 95% CI (- 0.15, 0.065)]. There was no difference in the rate of concordance between FNA and core biopsy by lesion location or FNA needle gauge size (P > 0.05).

Conclusion: FNA with core biopsy increases diagnostic rate compared to core biopsy alone or FNA alone. The concordance between FNA and core biopsy is higher for lytic lesions than for blastic lesions; and higher for low-attenuation lesions than for high-attenuation lesions.

Keywords: Blastic; Bone lesions; CT attenuation; FNA; Fine-needle aspiration; Lytic; Metastases; Osseous lesions.

Publication types

Comparative Study

MeSH terms

Biopsy, Fine-Needle
Biopsy, Large-Core Needle
Bone Neoplasms / diagnostic imaging*
Bone Neoplasms / pathology*
Female
Humans
Male
Middle Aged
Retrospective Studies
Tomography, X-Ray Computed