Accuracy of Percutaneous CT-Guided Spine Biopsy and Determinants of Biopsy Success

Purpose: The purpose of this study was to investigate the accuracy of CT-guided spine biopsy as well as the factors that may influence its success.

Methods and materials: A total of 170 CT-guided biopsies performed on 156 patients with vertebral lesions were retrospectively analyzed. The accuracy of the biopsies was evaluated by comparing the final diagnosis with the biopsy results for patients who underwent surgery or with six-month clinical and radiological follow-up findings for patients who did not have surgery. The radiological features of each lesion, the features of the needles used, the needle approach, the pathology results, and the patient demographic data were statistically analyzed with Fisher exact test and ANOVA for their influence on the success of the biopsy.

Results: The total success rate of percutaneous vertebral needle biopsies performed with CT guidance was 80 per cent (136/170). Age (p = 0.39), gender (p = 0.43), lesion location (p = 0.2), radiographic appearance (p = 0.8), needle type (p = 0.6), and approach (p = 0.1) had no effect on the adequacy of the obtained material or the success of the biopsy. There was a relationship between lesion histopathology and the rate of adequacy or success (p < 0.001). There was no relationship between the needle approach or the radiographic appearance of the lesion and the length of the specimen (p = 0.1). There were no major complications requiring treatment.

Conclusion: The success rate of CT-guided percutaneous needle biopsy was close to that found in previous studies in the literature and independent of most patient parameters. Its complication rates are acceptable in experienced hands.