MRI-Guided Percutaneous Transpedicular Biopsy of Thoracic and Lumbar Spine Using a 0.23T Scanner With Optical Instrument Tracking

Purpose: To prospectively evaluate the safety and accuracy of magnetic resonance imaging (MRI)-guided percutaneous transpedicular biopsy of thoracic and lumbar spine using 0.23T magnetic resonance imaging with optical tracking. Materials and Methods: Sixty-seven thoracic and lumbar spine lesions in 67 patients underwent MRI-guided percutaneous transpedicular biopsy using 0.23T MRI with optical tracking. These lesions were divided into two groups according to the location: 16 lesions in the thoracic spine and 51 lesions in the lumbar spine. The diagnostic accuracy, sensitivity, and specificity were calculated, and comparison of the two groups was performed using Fisher's exact test. Each patient was monitored for complications. Results: All specimens obtained were sufficient for diagnosis. Histological examination of MRI-guided percutaneous biopsy revealed 38 malignant and 29 benign lesions. The final diagnoses from surgery or clinical follow-up were 42 malignant lesions and 25 benign lesions. The combined diagnostic performance of MRI-guided percutaneous transpedicular thoracic and lumbar biopsy in diagnosing malignant tumors was as follows: accuracy, 94%; sensitivity, 89%; and specificity, 100%. There was no significant difference between the two groups (P=1, Fisher's exact test). No serious complications occurred. Conclusion: MRI-guided percutaneous transpedicular biopsy is a safe and accurate diagnostic technique to evaluate thoracic and lumbar spine lesions.