Current Use, Effectiveness, and Safety of Image-Guided Bone Biopsies: Insights from the Registry of the German Society for Interventional Radiology and Minimally Invasive Therapy (DeGIR) Data 2018–2022

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Image-guided bone biopsies have become indispensable in the diagnosis of a wide range of diseases, from incidental suspicious lesions to the evaluation of treatment response and the staging of malignancies. The aim of this evaluation of the prospectively managed voluntary multinational registry of the German Society for Interventional Radiology and Minimally Invasive Therapy (DeGIR) was to analyze the use, technical success, and complications of image-guided diagnostic biopsies of bone lesions.All bone biopsies reported in the DeGIR registry between 2018 and 2022 were included. Technical success was defined as the successful image-guided placement of the sampling device within the bone lesion. Technical success and complication rates were compared across various parameters by Fisher's exact and chi-square test. p<0.05 was considered statistically significant.A total of 17397 diagnostic punctures (female: 52% (9046/17397), outpatient procedures: 34% (5924/17397), median age: 64y (IQR 51-75y)) from 214 centers in Germany, Austria, and Switzerland were analyzed. The technical success rate was 98.9% (17201/17397), with histological representativeness in 93.2% of cases (10316/11071). Outpatient procedures had a higher technical success rate (99.3%, 5884/5924) compared to inpatient procedures (98.6%, 11316/11473, p<0.0001), but lower histological representativeness (91.1%, 1284/1410 vs. 93.5%, 9031/9661, p=0.001). The overall complication rate was 0.62% (108/17397), with major complications being predominantly parenchymal bleeding. Solid or subsolid lesions had higher histological representativeness (94.0%, 7846/8346) compared to necrotic-cystic lesions (90.3%, 1558/1725, p<0.0001).Image-guided bone biopsies are highly effective and safe. The high technical success rates and low complication rates underscore their clinical utility. The DeGIR registry provides valuable insight into the performance and outcomes of these procedures, highlighting their importance in interventional radiology. · Image-guided bone biopsies have a high technical success rate.. · The complication rate is generally low, with major complications being rare.. · The further reduction of complications in patients with normal coagulation parameters indicate that bone biopsies might be safely performed as outpatient procedures.. · Zensen S, Opitz MK, Behr F et al. Current Use, Effectiveness, and Safety of Image-Guided Bone Biopsies: Insight from the Registry of the German Society for Interventional Radiology and Minimally Invasive Therapy (DeGIR) Data 2018-2022. Rofo 2025; DOI 10.1055/a-2600-3915.