Clinical utility of a postprocedural CT scan in CT-guided musculoskeletal biopsies

Skeletal Radiol. 2020 Feb;49(2):257-262. doi: 10.1007/s00256-019-03279-w. Epub 2019 Jul 20.


Objective: The purpose of this study is first to determine the clinical utility of the postprocedure scan in detecting postinterventional complications after CT-guided musculoskeletal biopsies, and second to evaluate the contribution to the radiation dose of the postprocedural CT scan.

Materials and methods: Retrospective analysis of 500 consecutive CT-guided musculoskeletal biopsies over an 18-month period from 29 March 2017 to 28 September 2018, where spiral postprocedure scans were obtained in every case. To assess the clinical utility of postinterventional CT scans, it was determined whether immediate post-procedural complications were detected on the postprocedural scans only or were also seen on the procedural images. To evaluate the relative radiation exposure of postprocedural scans, a ratio was obtained of the dose-length product (DLP) of the postprocedural scan compared with the total DLP of each case.

Results: A total of 397 bone biopsies and 103 soft-tissue biopsies were performed in 471 patients. The immediate postprocedural complication rate was 0.4% (2 out of 500) in all procedures. Both complications were minor (small hematomas) and detected only on postinterventional CT scans. The average total DLP for the procedures was 383.5 mGy*cm. The average DLP of the postprocedural scan was 64.0 mGy*cm. The average radiation dose contribution of the postprocedural CT scans toward the total DLP was 17.4%.

Conclusion: Immediate postprocedural complications in CT-guided musculoskeletal interventions are rare. When complications do occur, they are usually minor. To substantially reduce radiation dose, postinterventional CT scans should not be performed routinely.

Keywords: CT-guided biopsy; Complication rate; Postprocedure CT scan; Radiation dose.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bone and Bones / diagnostic imaging
  • Bone and Bones / pathology
  • Female
  • Humans
  • Image-Guided Biopsy
  • Male
  • Middle Aged
  • Muscles / diagnostic imaging
  • Muscles / pathology
  • Musculoskeletal Diseases / diagnostic imaging*
  • Musculoskeletal Diseases / pathology*
  • Radiation Dosage
  • Radiography, Interventional / methods*
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods*
  • Young Adult