Accuracy of core needle biopsy for the diagnosis of osteosarcoma: A retrospective analysis of 73 patients

Abstract Purpose The goals of this retrospective study were to evaluate the accuracy of core needle biopsy (CNB) for the diagnosis of osteosarcoma and to identify criteria that may predict failed CNB. Materials and methods From 2002 to 2012, 73 patients with a total of 73 osteosarcomas underwent CNB. Patients demographics and procedure details were recorded, including tumor size, tumor characteristics (hemorrhagic or not, lytic, sclerotic [> 50% bone condensation], or mixed), the type of anesthesia, the number of tissue samples, the size of the biopsy needle and pathology report. Procedures were analyzed in terms of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Results A diagnosis was not made in 5/73 patients (6.8%) with an overall sensitivity of 93.1%, a specificity of 100%, a PPV of 100% and a NPV of 99.9%. No complications due to CNB were observed. No criteria were identified as predictors of CNB failure. Conclusion Even in the presence of sclerotic tumors, CNB should be the first line diagnostic test for suspected osteosarcomas, pending performance by a well-trained radiologist and reading by a specialized pathologist. Level of evidence IV.