• Chong Hyun Suh and Seong Jong Yun.
• 1 Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
• AJR Am J Roentgenol. 2019 Mar 1; 212 (3): 625-631.

ObjectiveThis systematic review and meta-analysis aimed to evaluate the diagnostic outcome (diagnostic yield and accuracy) of image-guided percutaneous core needle biopsy (CNB) of sclerotic bone lesions.Materials And MethodsA computerized search of the PubMed and EMBASE databases was performed to identify relevant original articles on the use of image-guided percutaneous CNB of sclerotic bone lesions. The pooled proportions of the diagnostic yield and pooled accuracy estimates were assessed using random-effects modeling. We also performed subgroup analyses of the diagnostic yield according to the drill systems (battery-powered vs manual). Heterogeneity among studies was determined using the inconsistency index (I2). Meta-regression analyses were performed to evaluate the potential sources of heterogeneity.ResultsFifteen eligible studies, involving 969 sclerotic bone lesions for diagnostic yield, and 242 sclerotic bone lesions for diagnostic accuracy, were included. The pooled proportion of the diagnostic yield of image-guided percutaneous CNB of sclerotic bone lesions was 74% (95% CI, 62-84%), and the pooled accuracy estimate for differentiation between benign and malignant lesions was 87% (95% CI, 77-93%). In the subgroup analysis, the pooled proportion of the diagnostic yield of the battery-powered drill system (76.7% [95% CI, 64.0-85.8%]) was higher than that of the manual drill system (65.2% [95% CI, 58.0-71.8%]). In the meta-regression analyses, no variables were significantly different (p = 0.13-0.93).ConclusionIn conclusion, we determined that image-guided percutaneous CNB of sclerotic bone lesions is an accurate diagnostic technique with good diagnostic yield, particularly when the battery-powered bone biopsy system is used.

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