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The diagnostic significance of repeat ultrasound-guided biopsy of musculoskeletal soft-tissue lesions with initially inconclusive biopsy results

Loudini, N., Glaudemans, A. W. J. M., Jutte, P. C., Suurmeijer, A. J. H., Yakar, D. & Kwee, T. C., Jul-2019, In : European Journal of Surgical Oncology. 45, 7, p. 1266-1273 8 p.

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DOI

Introduction: To determine the diagnostic yield of repeat ultrasound (US)-guided biopsy of musculoskeletal soft-tissue lesions with initially inconclusive biopsy results, and to explore predictive factors for success of repeat biopsy.

Materials and methods: This retrospective study included 42 patients who underwent a repeat (second) US-guided biopsy session to target a musculoskeletal soft-tissue lesion because an initial US-guided biopsy session provided inconclusive results. Both biopsy sessions were performed in a tertiary referral center for soft-tissue sarcomas.

Results: The diagnostic yield of repeat US-guided biopsy was 47.6%. Malignant nature of the lesion (P = 0.031), sharp lesion borders on US (P = 0.011), and good to very good lesion visibility on US (P = 0.017) were significantly associated with a diagnostic repeat US-guided biopsy. There was also a trend towards significance (P = 0.073) for a higher number of biopsy passes through the lesion. Other patient characteristics (age and gender), magnetic resonance imaging features (lesion homogeneity on T1-weighted, T2-weighted, and gadolinium chelate enhanced sequences, borders, enhancement pattern, depth and size), US features (lesion appearance, vascular flow, and depth), biopsy-related factors (days between initial and repeat US-guided biopsy, needle diameter, maximum length of acquired samples), and operator-related factors (same or different radiologists/pathologists for initial and repeat biopsies), were not associated with the diagnostic success of the repeat US-guided biopsy.

Conclusions: Repeat US-guided biopsy of a musculoskeletal soft-tissue lesion with initially inconclusive biopsy results can be useful to establish a final diagnosis. Lesion features on US (borders and visibility) may be used to prospectively determine the utility of a repeat US-guided biopsy. (C) 2019 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Original languageEnglish
Pages (from-to)1266-1273
Number of pages8
JournalEuropean Journal of Surgical Oncology
Volume45
Issue number7
Early online date29-Jan-2019
Publication statusPublished - Jul-2019

    Keywords

  • Biopsy, Musculoskeletal system, Sarcoma, Soft tissue neoplasms, Ultrasonography, CORE NEEDLE-BIOPSY, TUMOR-LIKE LESIONS, BONE

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