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

Michael G. Holmes, Erik Foss, Gabby Joseph, Adam Foye, Brooke Beckett, Daria Motamedi, Jack Youngren, George Thomas, Jiaoti Huang, Rahul Aggarwal, Joshi Alumkal, Tomasz (Tom) Beer, Eric J. Small, Thomas M. Link

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Purpose: 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. Materials and Methods: 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. Results: 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). Conclusions: 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.

Original languageEnglish (US)
JournalJournal of Vascular and Interventional Radiology
DOIs
StateAccepted/In press - Dec 19 2016

Fingerprint

Castration
Prostatic Neoplasms
Biopsy
Bone and Bones
Neoplasms
Sclerosis
Alkaline Phosphatase
RNA Sequence Analysis
Cell Separation
Multicenter Studies
Histology
RNA
Neoplasm Metastasis
Growth

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

CT-Guided Bone Biopsies in Metastatic Castration-Resistant Prostate Cancer : Factors Predictive of Maximum Tumor Yield. / Holmes, Michael G.; Foss, Erik; Joseph, Gabby; Foye, Adam; Beckett, Brooke; Motamedi, Daria; Youngren, Jack; Thomas, George; Huang, Jiaoti; Aggarwal, Rahul; Alumkal, Joshi; Beer, Tomasz (Tom); Small, Eric J.; Link, Thomas M.

In: Journal of Vascular and Interventional Radiology, 19.12.2016.

Research output: Contribution to journalArticle

Holmes, Michael G. ; Foss, Erik ; Joseph, Gabby ; Foye, Adam ; Beckett, Brooke ; Motamedi, Daria ; Youngren, Jack ; Thomas, George ; Huang, Jiaoti ; Aggarwal, Rahul ; Alumkal, Joshi ; Beer, Tomasz (Tom) ; Small, Eric J. ; Link, Thomas M. / CT-Guided Bone Biopsies in Metastatic Castration-Resistant Prostate Cancer : Factors Predictive of Maximum Tumor Yield. In: Journal of Vascular and Interventional Radiology. 2016.
@article{c0f90eb798044b5ca2a9e0aa05de1163,
title = "CT-Guided Bone Biopsies in Metastatic Castration-Resistant Prostate Cancer: Factors Predictive of Maximum Tumor Yield",
abstract = "Purpose: 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. Materials and Methods: 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. Results: 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). Conclusions: 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.",
author = "Holmes, {Michael G.} and Erik Foss and Gabby Joseph and Adam Foye and Brooke Beckett and Daria Motamedi and Jack Youngren and George Thomas and Jiaoti Huang and Rahul Aggarwal and Joshi Alumkal and Beer, {Tomasz (Tom)} and Small, {Eric J.} and Link, {Thomas M.}",
year = "2016",
month = "12",
day = "19",
doi = "10.1016/j.jvir.2017.04.019",
language = "English (US)",
journal = "Journal of Vascular and Interventional Radiology",
issn = "1051-0443",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - CT-Guided Bone Biopsies in Metastatic Castration-Resistant Prostate Cancer

T2 - Factors Predictive of Maximum Tumor Yield

AU - Holmes, Michael G.

AU - Foss, Erik

AU - Joseph, Gabby

AU - Foye, Adam

AU - Beckett, Brooke

AU - Motamedi, Daria

AU - Youngren, Jack

AU - Thomas, George

AU - Huang, Jiaoti

AU - Aggarwal, Rahul

AU - Alumkal, Joshi

AU - Beer, Tomasz (Tom)

AU - Small, Eric J.

AU - Link, Thomas M.

PY - 2016/12/19

Y1 - 2016/12/19

N2 - Purpose: 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. Materials and Methods: 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. Results: 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). Conclusions: 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.

AB - Purpose: 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. Materials and Methods: 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. Results: 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). Conclusions: 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.

UR - http://www.scopus.com/inward/record.url?scp=85019567976&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85019567976&partnerID=8YFLogxK

U2 - 10.1016/j.jvir.2017.04.019

DO - 10.1016/j.jvir.2017.04.019

M3 - Article

C2 - 28549709

AN - SCOPUS:85019567976

JO - Journal of Vascular and Interventional Radiology

JF - Journal of Vascular and Interventional Radiology

SN - 1051-0443

ER -