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

Authors
  • Li, John1
  • Weissberg, Zoe1
  • Bevilacqua, Thomas A.1
  • Yu, Gordon2
  • Weber, Kristy3
  • Sebro, Ronnie1
  • 1 University of Pennsylvania, Department of Radiology, 3400 Spruce Street, Philadelphia, PA, 19104, USA , Philadelphia (United States)
  • 2 University of Pennsylvania, Department of Pathology, 3400 Spruce Street, Philadelphia, PA, 19104, USA , Philadelphia (United States)
  • 3 University of Pennsylvania, Department of Orthopedic Surgery, 3400 Civic Center Blvd, Perelman Center South Tower, Room 10-179, Philadelphia, PA, 19104, USA , Philadelphia (United States)
Type
Published Article
Journal
La radiologia medica
Publisher
Springer Milan
Publication Date
Dec 16, 2017
Volume
123
Issue
4
Pages
254–259
Identifiers
DOI: 10.1007/s11547-017-0841-8
Source
Springer Nature
Keywords
License
Yellow

Abstract

ObjectivesTo compare the concordance between fine-needle aspiration and core biopsies for osseous lesions by lesion imaging appearance and CT attenuation.Materials and methodsRetrospective 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.ResultsCore 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).ConclusionFNA 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.

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