• Curr Probl Diagn Radiol · Nov 2019

    CT-Guided Percutaneous Spine Biopsy Specimen Adequacy, Pathology Concordance, and Negative Predictive Value with Battery-Powered Drill and Manual Approaches.

    • Jeffrey P Guenette, Charles H Cho, Raymond Y Huang, Nityanand Miskin, Varand Ghazikhanian, and Thomas C Lee.
    • Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. Electronic address: jpguenette@bwh.harvard.edu.
    • Curr Probl Diagn Radiol. 2019 Nov 1; 48 (6): 558-562.

    ObjectiveDetermine computed tomography-guided percutaneous spine biopsy specimen adequacy, pathology-imaging concordance, and negative predictive value with battery-powered drill vs manual approach.Materials And MethodsOne-hundred-fourteen consecutive computed tomography-guided percutaneous spine biopsies in 109 patients (age: 61.1 ± 15.4 years; range: 17-90 years; males: 55, 50.5%; females: 54, 49.5%) performed at a single institution from September 2013 through January 2017 were retrospectively reviewed. Specimen adequacy was recorded. Imaging-pathology concordance was assessed. Chi-square tests compared specimen adequacy and imaging-pathology concordance obtained with a battery-powered drill vs manual approach. Negative predictive values were calculated.ResultsBattery-powered drill yielded slightly better, but not statistically significant, specimen adequacy (96% vs 90% overall, P = 0.270; 96% vs 89% for suspected neoplasm, P = 0.278; 95% vs 90% for suspected infection, P = 0.514), pathology-imaging concordance (82% vs 74% overall, P = 0.301; 92% vs 77% for suspected neoplasm, P = 0.107; 71% vs 65% for suspected infection, P = 0.602), and negative predictive value (65% vs 41% overall; 75% vs 33% for suspected neoplasm; 58% vs 33% for suspected infection). Four battery-powered drill procedures were technically unsuccessful.ConclusionsUse of a battery-powered drill appears to yield similar to slightly better spine biopsy specimens than a manual approach, but also appears to carry a greater risk of technical failure. The battery-powered drill may be particularly helpful for procedures with complex approaches, but trajectory planning remains of paramount importance.Copyright © 2018 Elsevier Inc. All rights reserved.

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