Abstract No. 503 Image-guided bone marrow biopsies: pathological comparison of marrow specimen quality obtained using a Mallet versus without

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Bone marrow trephine core biopsies can be obtained with the use of a mallet or without. Anecdotal information from our pathologists suggested mallet obtained samples appeared to have more artifacts. The purpose of this study was to objectively investigate this concern raised by our pathologists. We performed a double-blinded, retrospective review of bone marrow biopsies collected by the interventional radiology department at our institution between January and June 2015. Routine bone marrow core biopsy slides were reviewed. The presence of crush artifact, specimen fragmentation, and aspiration artifact, as well as the presence of osteopenia and an overall grade of specimen adequacy, was recorded for each specimen. There were 93 bone marrow biopsy specimens collected during this period. A sterile mallet was used during the bone marrow biopsy procedure in 29 cases. Use of a mallet was significantly associated with the presence of suboptimal or inadequate specimen quality of bone marrow core biopsy (p<0.005) and was independently associated with severe specimen fragmentation (2+) (p<0.0001). There was no statistically significant association between length of the core and use of a mallet. Use of a mallet during bone marrow core biopsy collection is significantly associated with morphologic distortion in the form of severe specimen fragmentation and negatively affects specimen adequacy. There is no difference in length of core biopsy as previously thought by using a mallet to advance the needle during the procedure. We recommend that use of this technique should be avoided during specimen collection.