Diagnostic Accuracy and Charge-Savings of Outpatient Core Needle Biopsy Compared with Open Biopsy of Musculoskeletal Tumors*

作者：MARY CLAIRE SKRZYNSKI, J. Sybil Biermann, Anthony Montag, Michael A. Simon · 发表于：Journal of Bone and Joint Surgery · 年份：1996 · DOI：10.2106/00004623-199605000-00002 · 被引用次数：320 · 研究领域：Sarcoma Diagnosis and Treatment、Musculoskeletal synovial abnormalities and treatments、Bone Tumor Diagnosis and Treatments

We performed a prospective study of sixty-two patients who were managed with a closed core needle biopsy in an outpatient clinic for a soft-tissue mass or a bone tumor with soft-tissue extension between August 1, 1992, and June 1, 1994. Eight (13 percent) of the closed core needle biopsies yielded no neoplastic tissue. Two needle biopsies (3 percent), which were of myxomatous masses, did not allow distinction between a benign and a malignant neoplasm; both masses were extraskeletal myxoid chondrosarcomas. Additionally, the histological grade of four resected specimens (6 percent) differed from that determined with the closed needle biopsy. The diagnostic accuracy of the closed needle biopsies was 84 percent (fifty-two of sixty-two). All ten diagnostic errors involved soft-tissue tumors. A retrospective study of a similar cohort of patients who had open biopsy in an outpatient operating room by the same surgeon in a contemporary period in the same institution and with analysis by the same pathologist, revealed a diagnostic accuracy of 96 percent (forty-eight of fifty). The hospital charges for the closed core needle biopsy were $1106, compared with $7234 for the open biopsy. We concluded that core needle biopsy can be performed in an outpatient clinic with use of local anesthesia and that it is substantially less expensive and more convenient than open biopsy. This technique has an acceptable but definitely lower rate of accuracy compared with open biopsy, especially for soft-...