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CT guided versus non-image guided bone marrow aspiration and biopsy: Comparison of indications, specimen quality and cost.
Alshumrani, Yousef; Droukas, Daniel; Carney, Brian J; Willim, Robert; Brook, Alexander; Wu, Jim S.
Afiliación
  • Alshumrani Y; Department of Internal Medicine - Division of Radiology, King Khalid University, 7887 Alfara street, Abha 62529, Saudi Arabia; Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, United States of America.
  • Droukas D; Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, United States of America. Electronic address: ddrouka1@bidmc.harvard.edu.
  • Carney BJ; Department of Medicine, Division of Hematology and Hematologic Malignancies, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, United States of America. Electronic address: bjcarney@bidmc.harvard.edu.
  • Willim R; Department of Pathology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, United States of America. Electronic address: rwillim@bidmc.harvard.edu.
  • Brook A; Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, United States of America. Electronic address: abrook@bidmc.harvard.edu.
  • Wu JS; Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, United States of America. Electronic address: jswu@bidmc.harvard.edu.
Clin Imaging ; 113: 110236, 2024 Sep.
Article en En | MEDLINE | ID: mdl-39106655
ABSTRACT

PURPOSE:

To compare the indications, specimen quality, and cost of CT versus non-image guided bone marrow aspirate and biopsy (BMAB).

METHODS:

All CT and non-image guided BMAB performed from January 2013-July 2022 were studied. Body-mass-index (BMI), skin-to-bone distance, aspirate, and core specimen quality, and core sample length were documented. Indications for CT guided BMAB were recorded. Categorical variables were compared using chi-squared test and continuous variables using Mann-Whitney test. Analysis of per-biopsy factors used linear mixed-effect models to adjust for clustering. Cost of CT and non-image guided BMAB was taken from patient billing data.

RESULTS:

There were 301 CT and 6535 non-image guided BMABs studied. All CT guided BMAB were studied. A subset of 317 non-image guided BMAB was selected randomly from the top ten CT BMAB referrers. BMI (kg/m2) and skin-to-bone distance (cm) was higher in the CT versus the non-image guided group; 34.4 v 26.8, p < 0.0001; 4.8 v 2.5, p < 0.0001, respectively. Aspirate and core sample quality were not different between groups, p = 0.21 and p = 0.12, respectively. CT guided core marrow samples were longer, p < 0.0001. The most common CT BMAB referral indications were large body habitus (47.7 %), failed attempt (18.8 %) and not stated (17.4 %). Cost of a CT guided BMAB with conscious sedation was $3945 USD versus $310 USD for non-image guided.

CONCLUSION:

CT guided BMAB are commonly performed in patients with large body habitus and failed attempt. However, the cost is 12.7 fold higher with no increase in specimen quality. These findings can help referrers be cost conscious.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Médula Ósea / Tomografía Computarizada por Rayos X Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Imaging Asunto de la revista: DIAGNOSTICO POR IMAGEM Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Médula Ósea / Tomografía Computarizada por Rayos X Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Imaging Asunto de la revista: DIAGNOSTICO POR IMAGEM Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos