Radiology-pathology correlation for bone and soft tissue tumors or tumor-like masses: single institutional experience after implementation of a weekly conference.

Abstract

To determine the frequency of non-diagnostic and discordant results from bone and soft tissue biopsies performed at our institution over a 3-year period and to investigate whether implementation of a weekly musculoskeletal radiology-pathology correlation conference decreased the time to appropriate patient management in cases of discordance. Consecutive image-guided core needle biopsy results obtained over a 12month period of time were reviewed in a retrospective fashion. Following implementation of the correlation conference, subsequent consecutive image-guided core needle biopsy results obtained over a 26month period of time were reviewed in a prospective fashion. For non-diagnostic and discordant cases, the time in days from date of availability of the biopsy result to date of documentation of a specific follow-up action plan was recorded. Diagnostic yield was 96.5% and 94.9% for the retrospective and prospective periods, respectively. There were four discordant results in the retrospective cohort (1.7%) and seven discordant results in the prospective cohort (2.1%). Following implementation of the weekly correlation conference, there was significant decrease (p< 0.05) in median time from a discordant biopsy result to follow-up action plan. There were no unnecessary surgeries, litigation, or other unfavorable consequences in either cohort. Image-guided core needle biopsies of bone and soft tissue provide high diagnostic yield, often with specific diagnoses. The statistically significant decrease in number of days to follow-up action plan for discordant results suggests radiology-pathology review has a positive impact on patient care. Subjective benefits from communication and educational standpoints are also noteworthy.