Current Use, Effectiveness, and Safety of Image-Guided Bone Biopsies: Insights from the Registry of the German Society for Interventional Radiology and Minimally Invasive Therapy (DeGIR) Data 2018–2022

Abstract

Purpose

Image-guided bone biopsies have become indispensable in the diagnosis of a wide range of diseases, from incidental suspicious lesions to the evaluation of treatment response and the staging of malignancies. The aim of this evaluation of the prospectively managed voluntary multinational registry of the German Society for Interventional Radiology and Minimally Invasive Therapy (DeGIR) was to analyze the use, technical success, and complications of image-guided diagnostic biopsies of bone lesions.

Materials and Methods

All bone biopsies reported in the DeGIR registry between 2018 and 2022 were included. Technical success was defined as the successful image-guided placement of the sampling device within the bone lesion. Technical success and complication rates were compared across various parameters by Fisher’s exact and chi-square test. p<0.05 was considered statistically significant.

Results

A total of 17397 diagnostic punctures (female: 52% (9046/17397), outpatient procedures: 34% (5924/17397), median age: 64y (IQR 51–75y)) from 214 centers in Germany, Austria, and Switzerland were analyzed. The technical success rate was 98.9% (17201/17397), with histological representativeness in 93.2% of cases (10316/11071). Outpatient procedures had a higher technical success rate (99.3%, 5884/5924) compared to inpatient procedures (98.6%, 11316/11473, p<0.0001), but lower histological representativeness (91.1%, 1284/1410 vs. 93.5%, 9031/9661, p=0.001). The overall complication rate was 0.62% (108/17397), with major complications being predominantly parenchymal bleeding. Solid or subsolid lesions had higher histological representativeness (94.0%, 7846/8346) compared to necrotic-cystic lesions (90.3%, 1558/1725, p<0.0001).

Conclusion

Image-guided bone biopsies are highly effective and safe. The high technical success rates and low complication rates underscore their clinical utility. The DeGIR registry provides valuable insight into the performance and outcomes of these procedures, highlighting their importance in interventional radiology.

Key Points

• Image-guided bone biopsies have a high technical success rate.

• The complication rate is generally low, with major complications being rare.

• The further reduction of complications in patients with normal coagulation parameters indicate that bone biopsies might be safely performed as outpatient procedures.

Citation Format

• Zensen S, Opitz MK, Behr F et al. Current Use, Effectiveness, and Safety of Image-Guided Bone Biopsies: Insight from the Registry of the German Society for Interventional Radiology and Minimally Invasive Therapy (DeGIR) Data 2018–2022. Rofo 2025; DOI 10.1055/a-2600-3915

Zusammenfassung

Ziel

Bildgesteuerte Knochenbiopsien sind in der Diagnostik eines breiten Krankheitsspektrums unverzichtbar geworden, von zufälligen verdächtigen Läsionen bis hin zur Beurteilung des Therapieansprechens und des Stagings von Malignomen. Ziel dieser Auswertung des freiwilligen multinationalen Registers der Deutschen Gesellschaft für Interventionelle Radiologie und minimalinvasive Therapie (DeGIR) war es, den Einsatz, den technischen Erfolg und die Komplikationen bildgesteuerter diagnostischer Biopsien von Knochenläsionen zu analysieren.

Material und Methoden

Eingeschlossen wurden alle Knochenbiopsien, die zwischen 2018 und 2022 an das DeGIR-Register gemeldet wurden. Technischer Erfolg wurde definiert als die erfolgreiche bildgesteuerte Platzierung der Biopsienadel innerhalb der Knochenläsion. Der technische Erfolg und die Komplikationsraten zwischen verschiedenen Parametern wurden mit dem exakten Fisher-Test und dem Chi-Quadrat-Test verglichen, wobei p<0,05 als statistisch signifikant angesehen wurde.

Ergebnisse

Insgesamt wurden 17397 diagnostische Biopsien von Knochenläsionen (weiblich: 52% (9046/17397), ambulante Eingriffe: 34% (5924/17397), mittleres Alter: 64 Jahre (IQR 51–75 Jahre)) aus 214 Zentren in Deutschland, Österreich und der Schweiz ausgewertet. Die technische Erfolgsrate lag bei 98,9% (17201/17397), die histologische Repräsentativität bei 93,2% (10316/11071). Bei ambulanten Eingriffen war die technische Erfolgsrate höher (99,3%, 5884/5924) als bei stationären Eingriffen (98,6%, 11316/11473, p<0,0001), die histologische Repräsentativität jedoch geringer (91,1%, 1284/1410 vs. 93,5 %, 9.031/9.661, p=0,001). Die Gesamtkomplikationsrate lag bei 0,62% (108/17397), wobei es sich bei den schwerwiegenden Komplikationen überwiegend um Parenchymblutungen handelte. Solide oder subsolide Läsionen waren histologisch repräsentativer (94,0%, 7846/8346) als nekrotisch-zystische Läsionen (90,3%, 1558/1725, p<0,0001).

Schlussfolgerung

Bildgesteuerte Knochenbiopsien sind sehr effektiv und sicher. Die hohen technischen Erfolgsraten und geringen Komplikationsraten unterstreichen ihren klinischen Nutzen. Das DeGIR-Register bietet wertvolle Einblicke in die Durchführung und die Ergebnisse dieser Verfahren und unterstreicht ihre Bedeutung in der interventionellen Radiologie.

Kernaussagen

• Bildgesteuerte Knochenbiopsien haben eine hohe technische Erfolgsrate.

• Die Komplikationsrate ist im Allgemeinen niedrig, wobei größere Komplikationen selten sind.

• Die sehr niedrige Komplikationsrate bei Patienten mit normalen Gerinnungsparametern deutet darauf hin, dass Knochenbiopsien bei ausgewählten Patienten sicher ambulant durchgeführt werden können.

Keywords

bone biopsy - bone lesions - register study - interventional radiology

Publication History

Received: 01 March 2025

Accepted after revision: 29 April 2025

Article published online:
23 May 2025

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