CT-Guided Bone Biopsies in Metastatic Castration-Resistant Prostate Cancer: Factors Predictive of Maximum Tumor Yield.

Published

Journal Article

To evaluate the success rate of CT-guided bone biopsies in metastatic castration-resistant prostate cancer (mCRPC) and to investigate associated technical, imaging, and clinical parameters affecting diagnostic yields.Eighty CT-guided bone biopsy specimens were obtained from 72 men (median age, 68 y; range, 49-89 y) enrolled in a multicenter trial to identify mechanisms of resistance in mCRPC. Successful biopsy was determined by histologic confirmation of tumor cells and successful isolation of RNA for molecular analysis.The overall success rate of CT-guided bone biopsies was 69% (55/80) based on histology and 64% (35/55) based on isolation of molecular material for RNA sequencing. Biopsies performed in lesions with areas of radiolucency had significantly higher diagnostic yields compared with lesions of predominantly dense sclerosis (95% vs 33%; P = .002) and lesions of predominantly subtle sclerosis (95% vs 65%; P = .04). Success rates increased in lesions with density ≤ 475 HU (79% for ≤ 475 HU vs 33% for > 475 HU; P = .001) and in lesions with ill-defined margins (76% for ill-defined margins vs 36% for well-circumscribed margins; P = .005). Alkaline phosphatase was the only clinical parameter to correlate significantly with diagnostic yield (83% for > 110 U/L vs 50% for ≤ 110 U/L; P = .001).Image-guided bone tumor biopsies can be successfully used to acquire cellular and molecular material for analyses in patients with osteoblastic prostate cancer metastases. Diagnostic yields are significantly increased in lesions with areas of radiolucency, density ≤ 475 HU, ill-defined margins, and interval growth and in patients with alkaline phosphatase > 110 U/L.

Full Text

Duke Authors

Cited Authors

  • Holmes, MG; Foss, E; Joseph, G; Foye, A; Beckett, B; Motamedi, D; Youngren, J; Thomas, GV; Huang, J; Aggarwal, R; Alumkal, JJ; Beer, TM; Small, EJ; Link, TM

Published Date

  • August 2017

Published In

Volume / Issue

  • 28 / 8

Start / End Page

  • 1073 - 1081.e1

PubMed ID

  • 28549709

Pubmed Central ID

  • 28549709

Electronic International Standard Serial Number (EISSN)

  • 1535-7732

International Standard Serial Number (ISSN)

  • 1051-0443

Digital Object Identifier (DOI)

  • 10.1016/j.jvir.2017.04.019

Language

  • eng