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Skeletal Radiology

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01-08-2020 | Foreign Body Aspiration | Scientific Article

CT-guided bone marrow aspirations and biopsies: retrospective study and comparison with blind procedures

Authors: C. Y. Chang, J. S. Husseini, A. Moreira, F. J. Simeone, A. J. Yee, M. A. Bredella, R. Hasserjian

Published in: Skeletal Radiology | Issue 8/2020

Abstract

Purpose

To compare the pathology results of CT-guided and blind bone marrow aspirations and biopsies.

Methods

Ninety-eight consecutive CT-guided biopsies and 98 age- and gender-matched blind (non-CT-guided) posterior iliac crest bone marrow aspirations and biopsies performed in 2017 were reviewed for adequacy of core biopsies and aspirate smears. CT procedure images and CT abdomen/pelvis images were reviewed to evaluate anatomic features of the posterior ilium and soft tissues. Statistical analysis was performed using a T test, Fisher exact test, and Kruskal-Wallis test.

Results

There was no significant difference in the age and gender of the two groups (p > 0.05). However, the CT-guided group had a higher BMI (p = 0.0049) and posterior soft tissue thickness (p = 0.0016). More CT-guided biopsy samples (CT 93 (95%); blind 77 (79%); p = 0.0006) and aspirate smears (CT 90 (92%); blind 78 (80%); p = 0.042) were categorized as adequate. The CT-guided group had longer core lengths (CT 1.4 ± 0.6 (range 0.3–3.5) cm; blind 1.0 ± 0.60 (range 0–2.6) cm; p = 0.0001). Overall, 131/164 (80%) of the cases had at least one of the described features (slanted posterior ilium (angle > 30°), 30%; rounded posterior ilium, 20%; thick posterior ilium cortex, 13%; focal lesion in posterior ilium, 12%; prior procedure in posterior ilium, 5%; posterior soft tissue thickness > 3 cm, 40%).

Conclusion

CT-guided bone marrow procedures were more likely to result in both adequate aspirate smears and biopsy samples and longer core lengths when compared with blind procedures.

Snover DC. Biopsy interpretation in bone marrow transplantation. Pathol Annu. 1989;24(Pt 2):63–101.PubMed

Islam A, Henderson ES. Value of long-core biopsy in the detection of discrete bone marrow lesions. Histopathology. 1988;12:641–8. https://doi.org/10.1111/j.1365-2559.1988.tb01988.x.CrossRefPubMed

Riley RS, Hogan TF, Pavot DR, et al. A pathologist’s perspective on bone marrow aspiration and biopsy: I. Performing a bone marrow examination. J Clin Lab Anal. 2004;18:70–90. https://doi.org/10.1002/jcla.20008.CrossRefPubMedPubMedCentral

Cohen SC, Gore JM. Evaluation of a powered intraosseous device for bone marrow sampling. Anticancer Res. 2008;28:3843–6.PubMed

Ibrahim HAH, Balachandran K, Bower M, Naresh KN. Bone marrow manifestations in multicentric Castleman disease. Br J Haematol. 2016;172:923–9. https://doi.org/10.1111/bjh.13919.CrossRefPubMed

Brackers de Hugo L, Ffrench M, Broussolle C, Sève P. Granulomatous lesions in bone marrow: clinicopathologic findings and significance in a study of 48 cases. Eur J Intern Med. 2013;24:468–73. https://doi.org/10.1016/j.ejim.2012.11.008.CrossRefPubMed

Mazher W, Ali J, Abubakar S, et al. Improvement in symptoms of Gaucher’s disease by enzyme replacement therapy. J Ayub Med Coll Abbottabad. 2018;30:479–81.PubMed

Jain S, Enzerra M, Mehta RS, et al. Bone marrow biopsies performed by both the powered OnControl drill device and the Jamshidi needle produce adequate specimens. J Clin Pathol. 2017;70:541–3. https://doi.org/10.1136/jclinpath-2016-204153.CrossRefPubMed

Berenson JR, Yellin O, Blumenstein B, et al. Using a powered bone marrow biopsy system results in shorter procedures, causes less residual pain to adult patients, and yields larger specimens. Diagn Pathol. 2011;6:23. https://doi.org/10.1186/1746-1596-6-23.CrossRefPubMedPubMedCentral

10.

Bishop PW, McNally K, Harris M. Audit of bone marrow trephines. J Clin Pathol. 1992;45:1105–8. https://doi.org/10.1136/jcp.45.12.1105.CrossRefPubMedPubMedCentral

11.

Abrams-Ogg ACG, Defarges A, Bienzle D. Comparison of feline core bone marrow biopsies from different sites using 2 techniques and needles. Vet Clin Pathol. 2014;43:36–42. https://doi.org/10.1111/vcp.12108.CrossRefPubMed

12.

Huang AJ, Kattapuram SV. Musculoskeletal neoplasms: biopsy and intervention. Radiol Clin N Am. 2011;49(1287–1305):vii. https://doi.org/10.1016/j.rcl.2011.07.010.CrossRef

13.

Skrzynski MC, Biermann JS, Montag A, Simon MA. Diagnostic accuracy and charge-savings of outpatient core needle biopsy compared with open biopsy of musculoskeletal tumors. J Bone Joint Surg Am. 1996;78:644–9.CrossRef

14.

Christner JA, Kofler JM, McCollough CH. Estimating effective dose for CT using dose-length product compared with using organ doses: consequences of adopting International Commission on Radiological Protection publication 103 or dual-energy scanning. AJR Am J Roentgenol. 2010;194:881–9. https://doi.org/10.2214/AJR.09.3462.CrossRefPubMed

15.

Huda W, Magill D, He W. CT effective dose per dose length product using ICRP 103 weighting factors. Med Phys. 2011;38:1261–5. https://doi.org/10.1118/1.3544350.CrossRefPubMed

16.

Bucher CM, Lehmann T, Tichelli A, et al. Comparison of a powered bone marrow biopsy device with a manual system: results of a prospective randomised controlled trial. J Clin Pathol. 2013;66:24–8. https://doi.org/10.1136/jclinpath-2012-201167.CrossRefPubMed

17.

Forwood KM, Lee E, Crispin PJ. Comparison of the bone marrow trephine sample quality between OnControl drill system and the Jamshidi needle. Int J Lab Hematol. 2019;41:373–9. https://doi.org/10.1111/ijlh.12984.CrossRefPubMed

18.

Glennon CA, Woodroof JM, Kambhampati S, et al. Comparison of bone marrow biopsy specimens obtained using a motorized device and manual biopsy systems. Asia Pac J Oncol Nurs. 2018;5:394–8. https://doi.org/10.4103/apjon.apjon_26_18.CrossRefPubMedPubMedCentral

19.

SH S, E C, NL H, et al WHO classification of tumours of haematopoietic and lymphoid tissues, 4th ed.

20.

Lee S-H, Erber WN, Porwit A, et al. ICSH guidelines for the standardization of bone marrow specimens and reports. Int J Lab Hematol. 2008;30:349–64. https://doi.org/10.1111/j.1751-553X.2008.01100.x.CrossRefPubMed

21.

You-Ten KE, Desai D, Postonogova T, Siddiqui N. Accuracy of conventional digital palpation and ultrasound of the cricothyroid membrane in obese women in labour. Anaesthesia. 2015;70:1230–4. https://doi.org/10.1111/anae.13167.CrossRefPubMed

22.

Stiffler KA, Jwayyed S, Wilber ST, Robinson A. The use of ultrasound to identify pertinent landmarks for lumbar puncture. Am J Emerg Med. 2007;25:331–4. https://doi.org/10.1016/j.ajem.2006.07.010.CrossRefPubMed

23.

Ellinas EH, Eastwood DC, Patel SN, et al. The effect of obesity on neuraxial technique difficulty in pregnant patients: a prospective, observational study. Anesth Analg. 2009;109:1225–31. https://doi.org/10.1213/ANE.0b013e3181b5a1d2.CrossRefPubMed

24.

Hudgins PA, Fountain AJ, Chapman PR, Shah LM. Difficult lumbar puncture: pitfalls and tips from the trenches. AJNR Am J Neuroradiol. 2017;38:1276–83. https://doi.org/10.3174/ajnr.A5128.CrossRefPubMed

25.

Frank ED, Long BW, Smith BJ. Merrill’s atlas of radiographic positioning & procedures. 11th ed. St. Louis, MO: Mosby Elsevier; 2007.

26.

Berrios LA. The ABCDs of managing morbidly obese patients in intensive care units. Crit Care Nurse. 2016;36:17–26. https://doi.org/10.4037/ccn2016671.CrossRefPubMed

27.

Siddiqui NA, Galizia MS, Almusa E, Omar IM. Evaluation of the tarsometatarsal joint using conventional radiography, CT, and MR imaging. Radiographics. 2014;34:514–31. https://doi.org/10.1148/rg.342125215.CrossRefPubMed

28.

Hemke R, Yang K, Husseini J, et al. Organ dose and total effective dose of whole-body CT in multiple myeloma patients. Skelet Radiol. 2020;49:549–54. https://doi.org/10.1007/s00256-019-03292-z.CrossRef

Title: CT-guided bone marrow aspirations and biopsies: retrospective study and comparison with blind procedures
Authors: C. Y. Chang
J. S. Husseini
A. Moreira
F. J. Simeone
A. J. Yee
M. A. Bredella
R. Hasserjian
Publication date: 01-08-2020
Publisher: Springer Berlin Heidelberg
Keywords: Foreign Body Aspiration
Foreign Body Aspiration
Aspiration
Published in: Skeletal Radiology / Issue 8/2020
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI: https://doi.org/10.1007/s00256-020-03423-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

CT-guided bone marrow aspirations and biopsies: retrospective study and comparison with blind procedures

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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