Percutaneous aspiration bone biopsy by fluoroscopic guidance.

Department of Radiology T h e advantages of pe rcu taneous need le aspira t ion of skeletal lesions were described in 1931 by Coley et al . T h e availability of image intensification, biplane f luoroscopy, and improved bone scanning techniques makes this p r o c e d u r e more feasible. T h e p r o c e d u r e is done u n d e r local anesthetic with sterile p repara t ion of the skin. T h e reasons for pe rcu taneous biopsy r a n g e f r o m the pat ient who is a poor surgical risk to the pat ient with metastatic disease who does not need surgical in tervent ion. 2 In addi t ion some biopsies a re done fo r suspected infect ion. Percu taneous biopsy has few risks and complications have been minimal . T h e advantage of f luoroscopic guidance is the accurate localization of the biopsy needle in the suspected area . Coley et al have aptly stated that even t h o u g h roen tgenography can establish correct o r nearly correct diagnosis in the majori ty of cases, histologic diagnosis is essential to avoid e r r o r . Aspirat ion is adaptable to all types of bone t u m o r s , except those in which the t u m o r is deeply situated and s u r r o u n d e d by a zone of no rma l bone t h r o u g h which the need le cannot pene t r a t e easily. Aspirat ion biopsy of bone is indicated in cases of infection o r fo r metastatic neoplasms