Diagnostic performance of computed tomography-guided percutaneous bone biopsy in musculoskeletal oncology: A single-center cohort study
Abstract
BACKGROUND: Computed tomography guided percutaneous bone biopsy provides tissue for the assessment of suspected primary and secondary bone lesions. Diagnostic yield, concordance with subsequent diagnostic assessment, and adverse events describe different aspects of performance. Their interpretation depends on case selection, outcome definitions, and the completeness and independence of diagnostic verification.
AIM: To describe diagnostic yield, recorded diagnostic concordance, and complications in a retrospective single-center cohort of image-guided bone biopsies.
METHODS: We retrospectively reviewed 64 consecutive image-guided percutaneous bone biopsy procedures performed from January 2023 through December 2025. Diagnostic yield required clinically useful histopathology without repeat sampling. Recorded concordance used a composite of surgical histopathology, immunohistochemistry-supported assessment, or clinical and imaging follow-up. Non-diagnostic procedures remained in the full-cohort analysis. Complications were classified using the legacy Society of Interventional Radiology system. Proportions were summarized with exact binomial 95% confidence intervals (CI); no external hypothesis tests were performed.
RESULTS: Diagnostic yield was 60/64 (93.75%; 95%CI: 84.8%-98.3%). Recorded concordance among 60 diagnostic, evaluable procedures was 60/60 (100%; 95%CI: 94.0%-100%). The full-cohort concordant diagnostic-result rate was 60/64 (93.75%) when four non-diagnostic procedures were counted as failures. Six biopsies revised the pre-procedural clinical diagnosis. Pelvic lesions were the most frequent sites. Two minor class B biopsy-tract fistulas occurred (2/64, 3.1%; 95%CI: 0.4%-10.8%); no major complications were recorded (0/64; 95%CI: 0%-5.6%). The heterogeneous cohort, incomplete verification reporting, and potentially non-independent composite reference standard limit interpretation of the conditional concordance estimate.
CONCLUSION: This cohort showed high diagnostic yield and two recorded minor complications. Conditional concordance does not establish unbiased diagnostic accuracy; independent verification and prospective confirmation are needed.
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BibTeX
@article{adam2026diagnostic,
title = {{Diagnostic performance of computed tomography-guided percutaneous bone biopsy in musculoskeletal oncology: A single-center cohort study}},
author = {Andreea Minodora Stuparu Adam and Alnuaimi Osama and Alexandru Stere and Daniel Cochior and Mark Eduard Pogărăşteanu and Cosmin Alec Moldovan and Ioan-Sorin Tudorache and Razvan Adam and Adina-Diana Moldovan},
journal = {World journal of radiology},
year = {2026},
month = oct,
doi = {10.4329/wjr.125901},
url = {https://europepmc.org/article/PMC/PMC13720579},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Diagnostic performance of computed tomography-guided percutaneous bone biopsy in musculoskeletal oncology: A single-center cohort study
AU - Andreea Minodora Stuparu Adam
AU - Alnuaimi Osama
AU - Alexandru Stere
AU - Daniel Cochior
AU - Mark Eduard Pogărăşteanu
AU - Cosmin Alec Moldovan
AU - Ioan-Sorin Tudorache
AU - Razvan Adam
AU - Adina-Diana Moldovan
PY - 2026
DA - 2026/10/28
JO - World journal of radiology
DO - 10.4329/wjr.125901
UR - https://europepmc.org/article/PMC/PMC13720579
AB - BACKGROUND: Computed tomography guided percutaneous bone biopsy provides tissue for the assessment of suspected primary and secondary bone lesions. Diagnostic yield, concordance with subsequent diagnostic assessment, and adverse events describe different aspects of performance. Their interpretation depends on case selection, outcome definitions, and the completeness and independence of diagnostic verification. AIM: To describe diagnostic yield, recorded diagnostic concordance, and complications in a retrospective single-center cohort of image-guided bone biopsies. METHODS: We retrospectively reviewed 64 consecutive image-guided percutaneous bone biopsy procedures performed from January 2023 through December 2025. Diagnostic yield required clinically useful histopathology without repeat sampling. Recorded concordance used a composite of surgical histopathology, immunohistochemistry-supported assessment, or clinical and imaging follow-up. Non-diagnostic procedures remained in the full-cohort analysis. Complications were classified using the legacy Society of Interventional Radiology system. Proportions were summarized with exact binomial 95% confidence intervals (CI); no external hypothesis tests were performed. RESULTS: Diagnostic yield was 60/64 (93.75%; 95%CI: 84.8%-98.3%). Recorded concordance among 60 diagnostic, evaluable procedures was 60/60 (100%; 95%CI: 94.0%-100%). The full-cohort concordant diagnostic-result rate was 60/64 (93.75%) when four non-diagnostic procedures were counted as failures. Six biopsies revised the pre-procedural clinical diagnosis. Pelvic lesions were the most frequent sites. Two minor class B biopsy-tract fistulas occurred (2/64, 3.1%; 95%CI: 0.4%-10.8%); no major complications were recorded (0/64; 95%CI: 0%-5.6%). The heterogeneous cohort, incomplete verification reporting, and potentially non-independent composite reference standard limit interpretation of the conditional concordance estimate. CONCLUSION: This cohort showed high diagnostic yield and two recorded minor complications. Conditional concordance does not establish unbiased diagnostic accuracy; independent verification and prospective confirmation are needed.
SN - 1949-8470
ER -