Diagnostic performance of computed tomography-guided percutaneous bone biopsy in musculoskeletal oncology: A single-center cohort study

Table 5 Selected external studies and reviews used for narrative context; outcomes are reported with their original populations and denominators, not pooled

Ref.	Design and population	Verified endpoint/finding	Interpretive boundary
Wang et al[16], 2019	Retrospective; 31 patients with bone lymphoma	Diagnosis and subtype established in 26/31 (83.9%). PET/CT findings informed target selection	Selected lymphoma population; not a general bone-tumor accuracy denominator
Dablan et al[17], 2025	Retrospective; 211 patients, 226 biopsies; CT and ultrasound guidance	Adequacy 148/211 patients (70.1%). Higher SUV was associated with adequacy within the PET-imaged subset	70.1% uses patients, not 226 procedures. Neither CT-only nor an external control group
Filippiadis et al[18], 2018	Narrative review of biopsy of bone metastases	Technical guidance on indication, targeting, specimen acquisition, and safety	No original study denominator; not an independent cohort or pooled performance estimate
Maciel et al[19], 2014	Retrospective; 186 procedures	Adequate material in 183/186 (98.4%); three complications, including fracture, functional paresthesia, and needle breakage requiring removal	Specimen adequacy is not verified diagnostic accuracy; complications were not all trivial
Ferreira et al[20], 2023	Systematic review/meta-analysis; 29 studies	Pooled CNB yield 91.4%, accuracy 92.7%; FNA yield 88.5%, accuracy 82.5%; combined yield 96.5%	Secondary evidence, not a separate primary cohort. Do not pool again with potentially overlapping primary reports
Li et al[21], 2014	Retrospective; 162 biopsies in 155 patients	Yield 81.5%; lytic 89.9% vs sclerotic 48.5%; lesions ≥ 3 cm 89.2% vs smaller lesions 73.4%	Associations belong to that study; size threshold is ≥ 3 cm. Repeated procedures may differ from unique patients
Hwang et al[22], 2011	Retrospective; 800 CT-guided bone biopsies	Initial results: 69% diagnostic, 31% indeterminate. CT features related to diagnostic/indeterminate outcomes were evaluated	Initial yield is distinct from subsequent final diagnosis. This is the CT-feature study, not Hoang et al[26]
Suh and Yun[23], 2019	Meta-analysis; 15 studies of sclerotic lesions	Pooled yield 74% (95%CI: 62%-84%; 969 lesions); accuracy 87% (95%CI: 77%-93%; 242 lesions)	Different denominators contribute to yield and accuracy. Restricted to sclerotic lesions
Toffart et al[24], 2020	Retrospective; 50 lytic lesions in patients suspected of lung cancer	Pathological diagnosis 50/50 (100%); molecular-testing success 35/37 (94.6%)	Molecular success is a separate endpoint among tested specimens, not overall biopsy accuracy
Monfardini et al[25], 2014	Retrospective; 308 procedures in 286 cancer patients	Adequacy 290/308 (94.1%); sensitivity 96.7% under the study’s diagnostic/follow-up definition	Adequacy and sensitivity are not interchangeable; final verification differed from the current cohort
Hoang et al[26], 2019	Retrospective; 115 patients with suspected osteomyelitis	Positive cultures in 24/115 (20.9%); treatment changed in 10 of the 24 culture-positive cases	Microbiological yield, not oncologic histopathological accuracy; not specific to bone tuberculosis

The table is a non-systematic selection of clinical cohorts and secondary evidence. Published estimates retain study-specific definitions and are not combined into a “literature average.” Bibliographic years refer to the issue publication year (Ferreira et al[20], 2023; Toffart et al[24], 2020). CNB: Core-needle biopsy; FNA: Fine-needle aspiration; SUV: Standardized uptake value; PET/CT: Positron emission tomography/computed tomography.