Combined CT-guided biopsy and cytology in diagnosis of bony lesions.

The results of 44 trephine (OD 1.4-4 mm) biopsies and 39 fine needle (0.7-0.9 mm) aspirations of skeletal, mainly vertebral, lesions performed under CT-guidance in 54 patients were evaluated. The fine needle sample was aspirated through the trephine as a complementary procedure in 29 patients and a fine needle aspiration only was performed in 10 patients. Trephine biopsy only was performed in 15 patients. Sufficient material for histologic and cytologic analyses was obtained in 93% (41/44) and 97% (38/39) and a correct benign or malignant diagnosis was obtained in 84% (37/44) and 90% (35/39), respectively. Among the combined examinations the fine needle aspiration alone was diagnostic in 2 cases while the trephine specimen alone provided diagnostic material in 2 cases. In 24 cases both the cytologic and histologic samples were adequate for diagnostic purposes. In one case both methods gave false-negative results. The combined use of cytologic and histologic samples in CT-guided bone biopsies increased diagnostic accuracy. The aorta was perforated once with a 1.4-mm needle but without sequelae. CT-guided bone biopsy was found to be a safe, reliable and cost-efficient method.