Image-Guided Percutaneous Biopsy for the Diagnosis of Musculoskeletal Tumors: An Analysis of 698 Cases and a Literature Review

Purpose: Incisional biopsy is still used to obtain material for a straightforward histological diagnosis in musculoskeletal lesions. The aim of our study was to evaluate 1) the percentage of diagnostic procedures, 2) diagnostic accuracy, and 3) the incidence of complications after imaging-guided percutaneous biopsy (PCB). Case Series: This is a retrospective analysis of imaging-guided PCB performed between January 2016 and September 2019 by fluoroscopy in bone lesions or under ultrasound-guidance in soft tissue lesions. Specimens were classified as diagnostic or non-diagnostic according to the pathologist’s report; diagnostic accuracy was determined by comparing histopathological results from biopsy and tumor resection. PCB was diagnostic in 94% and 97% of cases, with a diagnostic accuracy for detecting tumor disease in soft tissue and bone lesions of 98% and 100%, respectively. No complications were observed. Discussion: The PCB is safe, minimally invasive, and cost-effective; thus, it should be the gold standard for the diagnosis of musculoskeletal lesions.