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PT  - JOURNAL ARTICLE
AU  - McNamara, A.L.
AU  - Dickerson, E.C.
AU  - Gomez-Hassan, D.M.
AU  - Cinti, S.K.
AU  - Srinivasan, A.
TI  - Yield of Image-Guided Needle Biopsy for Infectious Discitis: A Systematic Review and Meta-Analysis
AID  - 10.3174/ajnr.A5337
DP  - 2017 Oct 01
TA  - American Journal of Neuroradiology
PG  - 2021--2027
VI  - 38
IP  - 10
4099  - http://www.ajnr.org/content/38/10/2021.short
4100  - http://www.ajnr.org/content/38/10/2021.full
SO  - Am. J. Neuroradiol.2017 Oct 01; 38
AB  - BACKGROUND: Image-guided biopsy is routinely conducted in patients with suspected discitis, though the sensitivity reported in the literature ranges widely.PURPOSE: We applied a systematic review and meta-analysis to estimate the yield of image-guided biopsy for infectious discitis.DATA SOURCES: We performed a literature search of 4 data bases: PubMed, Cochrane CENTRAL Register of Controlled Trials, Embase.com, and Scopus from data base inception to March 2016.STUDY SELECTION: A screen of 1814 articles identified 88 potentially relevant articles. Data were extracted for 33 articles, which were eligible if they were peer-reviewed publications of patients with clinical suspicion of discitis who underwent image-guided biopsy.DATA ANALYSIS: Patients with positive cultures out of total image-guided biopsy procedures were pooled to estimate yield with 95% confidence intervals. Hypothesis testing was performed with an inverse variance method after logit transformation.DATA SYNTHESIS: Image-guided biopsy has a yield of approximately 48% (793/1763), which is significantly lower than the open surgical biopsy yield of 76% (152/201; P &amp;lt; .01). Biopsy in patients with prior antibiotic exposure had a yield of 32% (106/346), which was not significantly different from the yield of 43% (336/813; P = .08) in patients without prior antibiotic exposure.LIMITATIONS: The conclusions of this meta-analysis are primarily limited by the heterogeneity of the included studies.CONCLUSIONS: Image-guided biopsy has a moderate yield for the diagnosis of infectious discitis, which is significantly lower than the yield of open surgical biopsy. This yield is not significantly affected by prior antibiotic use.