Adequacy of Powered vs Manual Bone Marrow Biopsy Specimens
Objectives To evaluate the quality and quantity of the bone marrow aspirates and biopsy specimens obtained with a powered system in comparison with the standard manual method.
Methods The Pathology Laboratory Information System was reviewed for patients who had previously undergone bone marrow biopsies performed by both the OnControl Bone Marrow System and the manual method. A total of 136 cases (68 patients) were reviewed for adequacy and compared using an unpaired t test.
Results The core biopsy specimens obtained by the OnControl system were significantly longer compared with those obtained by the manual system (16.9 vs 14.4 mm, P = .0036). However, the core biopsy specimens obtained by the manual method had on average more evaluable marrow elements (66% vs 40%, P < .0001), and the manual method was superior in 46 of the 68 cases when the length of evaluable marrow was calculated (9.7 vs 7 mm, P = .0049).
Conclusions Our findings show that longer core biopsy specimens are obtained by the OnControl Bone Marrow system but that the manual method is still superior when the percentage and length of evaluable bone marrow are analyzed.
Bone marrow examination is essential in diagnosing and staging hematologic disorders and is crucial in patient monitoring and follow-up. The traditional method for obtaining bone marrow specimens typically involves using two different needles through two adjacent sites. An aspirate is typically obtained first by an Illinois needle followed by a core or trephine biopsy of the medullary cavity by a Jamshidi needle (Argon Medical Devices, Athens, TX).
In 2007, the US Food and Drug Administration approved the OnControl Bone Marrow System (Vidacare, Shavano Park, TX) for obtaining samples for diagnostic examination. This medical device was recently implemented at our institution in the outpatient setting and is primarily used for patients with plasma cell myeloma. The drill was used in this patient population due to the difficulty in obtaining adequate specimens because of the routine use of bisphosphonates. Most of the literature regarding this device has focused on clinical aspects such as ease of use, length of procedures, and patient discomfort, but little has been written about adequacy of specimens obtained with this system. This study focuses on the quality and quantity of the specimens obtained by the powered bone marrow system in comparison with specimens obtained from the same patient by the manual method.
Abstract and Introduction
Abstract
Objectives To evaluate the quality and quantity of the bone marrow aspirates and biopsy specimens obtained with a powered system in comparison with the standard manual method.
Methods The Pathology Laboratory Information System was reviewed for patients who had previously undergone bone marrow biopsies performed by both the OnControl Bone Marrow System and the manual method. A total of 136 cases (68 patients) were reviewed for adequacy and compared using an unpaired t test.
Results The core biopsy specimens obtained by the OnControl system were significantly longer compared with those obtained by the manual system (16.9 vs 14.4 mm, P = .0036). However, the core biopsy specimens obtained by the manual method had on average more evaluable marrow elements (66% vs 40%, P < .0001), and the manual method was superior in 46 of the 68 cases when the length of evaluable marrow was calculated (9.7 vs 7 mm, P = .0049).
Conclusions Our findings show that longer core biopsy specimens are obtained by the OnControl Bone Marrow system but that the manual method is still superior when the percentage and length of evaluable bone marrow are analyzed.
Introduction
Bone marrow examination is essential in diagnosing and staging hematologic disorders and is crucial in patient monitoring and follow-up. The traditional method for obtaining bone marrow specimens typically involves using two different needles through two adjacent sites. An aspirate is typically obtained first by an Illinois needle followed by a core or trephine biopsy of the medullary cavity by a Jamshidi needle (Argon Medical Devices, Athens, TX).
In 2007, the US Food and Drug Administration approved the OnControl Bone Marrow System (Vidacare, Shavano Park, TX) for obtaining samples for diagnostic examination. This medical device was recently implemented at our institution in the outpatient setting and is primarily used for patients with plasma cell myeloma. The drill was used in this patient population due to the difficulty in obtaining adequate specimens because of the routine use of bisphosphonates. Most of the literature regarding this device has focused on clinical aspects such as ease of use, length of procedures, and patient discomfort, but little has been written about adequacy of specimens obtained with this system. This study focuses on the quality and quantity of the specimens obtained by the powered bone marrow system in comparison with specimens obtained from the same patient by the manual method.
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