2011 Mid-America Orthopaedic Association Dallas B. Phemister Physician in Training Award: Can Musculoskeletal Tumors be Diagnosed with Ultrasound Fusion-Guided Biopsy?
Summary of "2011 Mid-America Orthopaedic Association Dallas B. Phemister Physician in Training Award: Can Musculoskeletal Tumors be Diagnosed with Ultrasound Fusion-Guided Biopsy?"
BACKGROUND:
Percutaneous biopsy for musculoskeletal tumors commonly relies on imaging adjuncts including ultrasound (US), CT, or MRI. These modalities however have disadvantages (US) or are cumbersome, not universally available, and costly (CT and MRI). US fusion is a novel technique that fuses previously obtained CT or MRI data with real-time US, which allows biopsies to be performed in an US suite. It has proven useful in various body systems but musculoskeletal applications remain scarce. Our goal is to evaluate the fusion technology and determine its ability to diagnose musculoskeletal tumors. QUESTIONS/
PURPOSES:
We determined whether biopsies performed via US fusion compared with CT guidance provide equivalent diagnostic yield and accuracy and allow quicker biopsy scheduling and procedure times.
METHODS:
Forty-seven patients were assigned to undergo either US fusion (with MR, n = 16 or CT, n = 15) or CT-guided biopsies (n = 16). We evaluated adequacy of the histologic specimen (diagnostic yield) and correlation with surgical pathology (diagnostic accuracy). We determined scheduling times and lengths of the biopsy.
RESULTS:
US fusion and CT-guided biopsy groups had comparable diagnostic yields (CT = 94%; US/MRI = 94%; US/CT = 93%) and accuracy (CT = 83%; US/MRI = 90%; US/CT = 100%). US fusion biopsies were faster to schedule and perform. All procedures were safe with minimal complications.
CONCLUSIONS:
US fusion provides a high diagnostic yield and accuracy comparable to CT-guided biopsy while performed in the convenience of an US suite. This may have resulted in the observed faster scheduling and biopsy times. LEVEL OF
EVIDENCE:
Level II, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.
Affiliation
Department of Orthopaedics, Henry Ford Hospital, 2799 W Grand Boulevard, CFP-6, Detroit, MI, 48202, USA, jadkhalil@gmail.com.
Journal Details
This article was published in the following journal.
Name: Clinical orthopaedics and related research
ISSN: 1528-1132
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22644425
- DOI: http://dx.doi.org/10.1007/s11999-012-2405-5
Medical and Biotech [MESH] Definitions
Latin America
The geographic area of Latin America in general and when the specific country or countries are not indicated. It usually includes Central America, South America, Mexico, and the islands of the Caribbean.
Training Support
Financial support for training including both student stipends and loans and training grants to institutions.
Physician Impairment
The physician's inability to practice medicine with reasonable skill and safety to the patient due to the physician's disability. Common causes include alcohol and drug abuse, mental illness, physical disability, and senility.
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The general name for NORTH AMERICA; CENTRAL AMERICA; and SOUTH AMERICA unspecified or combined.
Allied Health Occupations
Occupations of medical personnel who are not physicians, and are qualified by special training and, frequently, by licensure to work in supporting roles in the health care field. These occupations include, but are not limited to, medical technology, physical therapy, physician assistant, etc.
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