Musculoskeletal Imaging Education
Musculoskeletal Image-Guided Procedures: CT-Guided Biopsy of a Malignant Bone Tumor
Bow Wang, M.D., his face flushed from struggling to drill the biopsy needle to obtain the specimen because the bone tumor was so hard.
Author: Bow Wang, M.D.
Mr. W, aged 67, was highly suspected of having malignant bone tumors in his spine and hip. After being hospitalized, he was referred by a hematologist/oncologist at National Cheng Kung University Hospital to Bow Wang, M.D. in the Department of Medicine for a biopsy of the bone lesion.
Due to the high degree of calcification and hardness of this bone lesion, a sufficient specimen for diagnosis was finally obtained after the combined efforts of multiple radiologists and two biopsies. The primary site of the bone metastasis was then determined by a pathologist.
The bone biopsy needle used to take the specimen, and the scabbed area on the palm where the needle was used.
A biopsy involves using a slightly invasive biopsy needle to extract a small amount of tissue from the tumor cells, which is then used by a pathologist for final diagnosis.
Generally, there are two main methods of biopsy: image-guided biopsy and surgical biopsy.
computed tomography (CT)-guided Bone Tumor Slicing
【image-guided-guided slicing】refers to using different medical imaging methods for localization, including ultrasound, X-ray, and computed tomography (CT). The method must be determined based on the depth and location of the tumor and the type of tissue it is located in. The advantage of this slicing method is that it can be performed without entering the operating room.
However, the 【image-guided-guided slicing】method also has its limitations, including:
1. Patient cooperation is required for the slicing procedure; therefore, this method cannot be used for young children or other patients who cannot cooperate.
2. This procedure requires an experienced radiologist.
3. This method is not suitable for image-guided slides in areas with no suitable pathway or extremely dangerous locations.
4. Sometimes, the amount of tumor specimen removed from the slide may be too small for pathologists to interpret.
Therefore, when necessary, it is still necessary for orthopedic surgeons or other specialists to perform the slide surgically after anesthesia in the operating room.
This page is for medical education and academic communication. It does not replace individual diagnosis or treatment advice.
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