Purpose: Although image-guided biopsies of bone and soft tissue lesions have a low complication rate, there is limited data evaluating use of preprocedural laboratory tests. To address this issue, patients were not required to stop non-steroidal antiinflammatory drugs (NSAIDs) and aspirin or to obtain preprocedural laboratory tests [complete blood count (CBC) and international normalized ratio (INR)], except in special circumstances. The bleeding complication rate, rate of same day biopsies, and the time from when the biopsy was ordered to when it was performed were obtained.
Materials and methods: A total of 332 patients who underwent bone or soft tissue biopsies performed at our institution between 9/1/2017 and 1/9/2019 were prospectively analyzed. These data were compared to a retrospective biopsy cohort of 323 patients between 7/1/2015 and 7/1/2017. Data collected included method of image guidance and bleeding complication rate. The number of days from ordering to performing a biopsy and number of same day biopsies were recorded.
Results: There were no bleeding complications in either cohort (OR 1.00, P = 1). The mean time from ordering to performing a bone biopsy was significantly decreased in the prospective group (6.6 days) compared to the retrospective group (8.1 days) (P = 0.012). There were more same day biopsies in the prospective cohort (11.4% vs. 3.4%) (P < 0.001).
Conclusions: Preprocedural CBC and INR for bone and soft tissue biopsies can be safely eliminated in most patients. Biopsies performed while patients are taking NSAIDs/aspirin can safely be performed. Adopting revised preprocedural laboratory criteria can result in decreased time to completion of biopsies.
Keywords: Biopsy; Bleeding; CBC; INR; Laboratory test; MSK.