Abstract：
OBJECTIVE: To evaluate diagnostic yield and accuracy of image-guided core needle biopsy (ICNB) of suspected malignant osseous lesions in a large cohort of adults, evaluate what factors influence these measures, and offer technical recommendations to optimize yield.
METHODS: A retrospective analysis of 2321 ICNBs performed from 2010 to 2021 was completed. The diagnostic yield and accuracy of the biopsies as well as a series of patient, lesion-related, and technical factors were retrospectively analyzed. Multivariate statistical analysis was performed to evaluate what factors were associated with yield and accuracy. Different cutoff values of total core length and core number were then tested to determine threshold values in relation to increased diagnostic yield.
RESULTS: Diagnostic yield was 98.2% (2279/2321) and accuracy was 97.6% (120/123). Increased total core length (odds ratio [OR] = 2.34, 95% confidence interval [CI] (1.41-3.90), p = 0.001), core number (OR = 1.51, 95% CI (1.06-2.16), p = 0.02) and presence of primary malignancy (OR = 2.81, 95% CI (1.40-5.62), p = 0.004) were associated with improved yield. Lesion location in an extremity (OR = 0.27, 95% CI (0.11-0.68), p = 0.006) and using fluoroscopic imaging guidance (OR = 0.33, 95% CI (0.12-0.90), p = 0.03) were associated with lower yield. Cutoff thresholds in relation to increased diagnostic yield were found to be 20 mm total core length (marginal OR = 4.16, 95% CI = (2.09-9.03), p < 0.001), and three total cores obtained (marginal OR = 2.78, 95% CI (1.34-6.54), p = 0.005). None of the analyzed factors influenced diagnostic accuracy.
CONCLUSIONS: ICNB has a high rate of diagnostic yield and accuracy. Several factors influence diagnostic yield; 20 mm core length and three total cores optimize yield.
CONCLUSIONS: Image-guided core needle biopsy of suspected malignant osseous lesions is a safe procedure with a very high rate of diagnostic yield and accuracy. Obtaining 20 mm total core length and three total cores optimizes diagnostic yield.
CONCLUSIONS: • In a retrospective cohort study, image-guided core needle biopsy of suspected osseous malignant lesions in adults was found to have very high rates of diagnostic yield and accuracy. • Increased total core length and core number of biopsies were each associated with increased diagnostic yield, and these relationships reached thresholds at 20 mm total core length and three total cores obtained. • The presence of a known primary malignancy was also associated with increased yield while using fluoroscopic imaging guidance and lesion location in an extremity were associated with decreased yield.
METHODS: A retrospective analysis of 2321 ICNBs performed from 2010 to 2021 was completed. The diagnostic yield and accuracy of the biopsies as well as a series of patient, lesion-related, and technical factors were retrospectively analyzed. Multivariate statistical analysis was performed to evaluate what factors were associated with yield and accuracy. Different cutoff values of total core length and core number were then tested to determine threshold values in relation to increased diagnostic yield.
RESULTS: Diagnostic yield was 98.2% (2279/2321) and accuracy was 97.6% (120/123). Increased total core length (odds ratio [OR] = 2.34, 95% confidence interval [CI] (1.41-3.90), p = 0.001), core number (OR = 1.51, 95% CI (1.06-2.16), p = 0.02) and presence of primary malignancy (OR = 2.81, 95% CI (1.40-5.62), p = 0.004) were associated with improved yield. Lesion location in an extremity (OR = 0.27, 95% CI (0.11-0.68), p = 0.006) and using fluoroscopic imaging guidance (OR = 0.33, 95% CI (0.12-0.90), p = 0.03) were associated with lower yield. Cutoff thresholds in relation to increased diagnostic yield were found to be 20 mm total core length (marginal OR = 4.16, 95% CI = (2.09-9.03), p < 0.001), and three total cores obtained (marginal OR = 2.78, 95% CI (1.34-6.54), p = 0.005). None of the analyzed factors influenced diagnostic accuracy.
CONCLUSIONS: ICNB has a high rate of diagnostic yield and accuracy. Several factors influence diagnostic yield; 20 mm core length and three total cores optimize yield.
CONCLUSIONS: Image-guided core needle biopsy of suspected malignant osseous lesions is a safe procedure with a very high rate of diagnostic yield and accuracy. Obtaining 20 mm total core length and three total cores optimizes diagnostic yield.
CONCLUSIONS: • In a retrospective cohort study, image-guided core needle biopsy of suspected osseous malignant lesions in adults was found to have very high rates of diagnostic yield and accuracy. • Increased total core length and core number of biopsies were each associated with increased diagnostic yield, and these relationships reached thresholds at 20 mm total core length and three total cores obtained. • The presence of a known primary malignancy was also associated with increased yield while using fluoroscopic imaging guidance and lesion location in an extremity were associated with decreased yield.
摘要：
目的：评估大量成人可疑恶性骨性病变的影像引导芯针活检（ICNB）的诊断率和准确性，评估哪些因素影响这些措施，并提供优化产量的技术建议。
方法：完成了对2010年至2021年进行的2321个ICNB的回顾性分析。活检的诊断产量和准确性以及一系列患者，病变相关,技术因素进行回顾性分析。进行多变量统计分析以评估哪些因素与产量和准确性相关。然后测试总核心长度和核心数量的不同截断值以确定与增加的诊断产量相关的阈值。
结果：诊断率为98.2%（2279/2321），准确率为97.6%（120/123）。总核心长度增加(比值比[OR]=2.34，95%置信区间[CI](1.41-3.90)，p=0.001),核心编号(OR=1.51，95%CI(1.06-2.16)，p=0.02)和原发性恶性肿瘤的存在(OR=2.81，95%CI(1.40-5.62)，p=0.004）与提高的产率相关。四肢病变位置(OR=0.27，95%CI(0.11-0.68)，p=0.006)并使用荧光成像指导(OR=0.33，95%CI(0.12-0.90)，p=0.03）与较低的产量有关。发现与诊断产量增加相关的截止阈值为20mm的总岩心长度(边际OR=4.16,95%CI=(2.09-9.03),p<0.001)，和获得的三个总岩心(边际OR=2.78，95%CI(1.34-6.54)，p=0.005)。所分析的因素均不影响诊断准确性。
结论：ICNB具有较高的诊断率和准确率。几个因素影响诊断产量;20毫米的核心长度和三个总核心优化产量。
结论：影像引导下可疑恶性骨性病变的粗针活检是一种安全的方法，具有很高的诊断率和准确率。获得20毫米的总核心长度和三个总核心优化诊断产量。
结论：•在一项回顾性队列研究中，对成人疑似骨性恶性病变的图像引导芯针活检被发现具有非常高的诊断率和准确率.•活检的总核心长度和核心数量增加均与诊断产量增加相关。这些关系在20毫米的总核心长度和三个总核心获得的阈值。•已知原发性恶性肿瘤的存在也与产量增加有关，而使用荧光成像指导和四肢病变位置与产量降低有关。
方法：完成了对2010年至2021年进行的2321个ICNB的回顾性分析。活检的诊断产量和准确性以及一系列患者，病变相关,技术因素进行回顾性分析。进行多变量统计分析以评估哪些因素与产量和准确性相关。然后测试总核心长度和核心数量的不同截断值以确定与增加的诊断产量相关的阈值。
结果：诊断率为98.2%（2279/2321），准确率为97.6%（120/123）。总核心长度增加(比值比[OR]=2.34，95%置信区间[CI](1.41-3.90)，p=0.001),核心编号(OR=1.51，95%CI(1.06-2.16)，p=0.02)和原发性恶性肿瘤的存在(OR=2.81，95%CI(1.40-5.62)，p=0.004）与提高的产率相关。四肢病变位置(OR=0.27，95%CI(0.11-0.68)，p=0.006)并使用荧光成像指导(OR=0.33，95%CI(0.12-0.90)，p=0.03）与较低的产量有关。发现与诊断产量增加相关的截止阈值为20mm的总岩心长度(边际OR=4.16,95%CI=(2.09-9.03),p<0.001)，和获得的三个总岩心(边际OR=2.78，95%CI(1.34-6.54)，p=0.005)。所分析的因素均不影响诊断准确性。
结论：ICNB具有较高的诊断率和准确率。几个因素影响诊断产量;20毫米的核心长度和三个总核心优化产量。
结论：影像引导下可疑恶性骨性病变的粗针活检是一种安全的方法，具有很高的诊断率和准确率。获得20毫米的总核心长度和三个总核心优化诊断产量。
结论：•在一项回顾性队列研究中，对成人疑似骨性恶性病变的图像引导芯针活检被发现具有非常高的诊断率和准确率.•活检的总核心长度和核心数量增加均与诊断产量增加相关。这些关系在20毫米的总核心长度和三个总核心获得的阈值。•已知原发性恶性肿瘤的存在也与产量增加有关，而使用荧光成像指导和四肢病变位置与产量降低有关。
