Predictive Factors Influencing Diagnostic Yield in Image-Guided Bone Biopsies: A Retrospective Analysis

Aim: To evaluate the factors that influence the diagnostic yield of image-guided percutaneous core needle biopsy (CNB) for bone lesions. Method: A retrospective analysis was conducted on 211 patients who underwent 226 image-guided percutaneous core needle biopsies for bone lesions between June 2020 and June 2024. The variables evaluated included patient age, lesion location, the modality used for biopsy guidance (ultrasound vs. CT), and pre-biopsy imaging techniques (PET/CT, MRI). Results: Diagnostic adequacy was achieved in 70.1% of cases. Key findings revealed that patients with adequate diagnostic yield were significantly older than those with inadequate yield (p=0.001). Lesions located in the lower extremity were more frequently associated with inadequate diagnostic yield (p=0.029), and the use of CT guidance was more common in this group (p<0.001). Additionally, pre-biopsy MRI use was higher in the inadequate yield group (p=0.005), while pre-biopsy PET scan use was lower (p=0.034). Among patients who underwent pre-biopsy PET scans, those with adequate diagnostic yield had significantly higher SUV values compared to those with inadequate yield (p=0.004) Conclusion: This study highlights key factors influencing diagnostic yield in bone biopsies, providing insights that can guide clinical decision-making. Understanding these factors may help improve diagnostic yield, aiding in appropriate treatment planning for patients with bone lesions.