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<meta name="DC.Title" content="Yield of Image-Guided Needle Biopsy for Infectious Discitis: A Systematic Review and Meta-Analysis" />
<meta name="DC.Identifier" content="10.3174/ajnr.A5337" />
<meta name="DC.Date" content="2017-09-07" />
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<meta name="DC.Description" content="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 &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." />
<meta name="DC.Contributor" content="A.L. McNamara" />
<meta name="DC.Contributor" content="E.C. Dickerson" />
<meta name="DC.Contributor" content="D.M. Gomez-Hassan" />
<meta name="DC.Contributor" content="S.K. Cinti" />
<meta name="DC.Contributor" content="A. Srinivasan" />
<meta name="article:published_time" content="2017-09-07" />
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<meta name="citation_title" content="Yield of Image-Guided Needle Biopsy for Infectious Discitis: A Systematic Review and Meta-Analysis" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND:&lt;/h3&gt;
&lt;p&gt;Image-guided biopsy is routinely conducted in patients with suspected discitis, though the sensitivity reported in the literature ranges widely.&lt;/p&gt;&lt;h3&gt;PURPOSE:&lt;/h3&gt;
&lt;p&gt;We applied a systematic review and meta-analysis to estimate the yield of image-guided biopsy for infectious discitis.&lt;/p&gt;&lt;h3&gt;DATA SOURCES:&lt;/h3&gt;
&lt;p&gt;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.&lt;/p&gt;&lt;h3&gt;STUDY SELECTION:&lt;/h3&gt;
&lt;p&gt;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.&lt;/p&gt;&lt;h3&gt;DATA ANALYSIS:&lt;/h3&gt;
&lt;p&gt;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.&lt;/p&gt;&lt;h3&gt;DATA SYNTHESIS:&lt;/h3&gt;
&lt;p&gt;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; &lt;i&gt;P&lt;/i&gt; &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; &lt;i&gt;P&lt;/i&gt; = .08) in patients without prior antibiotic exposure.&lt;/p&gt;&lt;h3&gt;LIMITATIONS:&lt;/h3&gt;
&lt;p&gt;The conclusions of this meta-analysis are primarily limited by the heterogeneity of the included studies.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;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.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="twitter:title" content="Yield of Image-Guided Needle Biopsy for Infectious Discitis: A Systematic Review and Meta-Analysis" />
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<meta name="twitter:description" content="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 &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." />
<meta name="og-title" property="og:title" content="Yield of Image-Guided Needle Biopsy for Infectious Discitis: A Systematic Review and Meta-Analysis" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/early/2017/09/07/ajnr.A5337" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="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 &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." />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node56079--5" data-node-nid="56079" id="top-node-56079--62005616801" data-pisa="ajnr;ajnr.A5337v1" data-pisa-master="ajnr;ajnr.A5337" data-apath="/ajnr/early/2017/09/07/ajnr.A5337.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
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      <h1 class="highwire-cite-title" id="page-title">Yield of Image-Guided Needle Biopsy for Infectious Discitis: A Systematic Review and Meta-Analysis</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">A.L. McNamara</span>, <span class="highwire-citation-author" data-delta="1">E.C. Dickerson</span>, <span class="highwire-citation-author" data-delta="2">D.M. Gomez-Hassan</span>, <span class="highwire-citation-author" data-delta="3">S.K. Cinti</span> and <span class="highwire-citation-author" data-delta="4">A. Srinivasan</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">September 2017,  </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A5337 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-56079--62005616801" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">A.L. McNamara </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the University of Michigan Health System (A.L.M., D.M.G.-H., S.K.C., A.S.), Ann Arbor, Michigan; and University of California, San Francisco (E.C.D.), San Francisco, California.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.L.%2BMcNamara%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=McNamara%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.L.%2BMcNamara%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-5555-4284" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A.L. McNamara</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">E.C. Dickerson </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the University of Michigan Health System (A.L.M., D.M.G.-H., S.K.C., A.S.), Ann Arbor, Michigan; and University of California, San Francisco (E.C.D.), San Francisco, California.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=E.C.%2BDickerson%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Dickerson%20E&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AE.C.%2BDickerson%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-3658-9422" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for E.C. Dickerson</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">D.M. Gomez-Hassan </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the University of Michigan Health System (A.L.M., D.M.G.-H., S.K.C., A.S.), Ann Arbor, Michigan; and University of California, San Francisco (E.C.D.), San Francisco, California.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.M.%2BGomez-Hassan%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Gomez-Hassan%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AD.M.%2BGomez-Hassan%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-6174-8210" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for D.M. Gomez-Hassan</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">S.K. Cinti </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the University of Michigan Health System (A.L.M., D.M.G.-H., S.K.C., A.S.), Ann Arbor, Michigan; and University of California, San Francisco (E.C.D.), San Francisco, California.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.K.%2BCinti%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Cinti%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AS.K.%2BCinti%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-8473-6274" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S.K. Cinti</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">A. Srinivasan </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the University of Michigan Health System (A.L.M., D.M.G.-H., S.K.C., A.S.), Ann Arbor, Michigan; and University of California, San Francisco (E.C.D.), San Francisco, California.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BSrinivasan%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Srinivasan%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.%2BSrinivasan%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-4400-1959" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A. 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      <div class="highwire-cite-title">Yield of Image-Guided Needle Biopsy for Infectious Discitis: A Systematic Review and Meta-Analysis</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">A.L.</span> <span class="nlm-surname">McNamara</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">E.C.</span> <span class="nlm-surname">Dickerson</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">D.M.</span> <span class="nlm-surname">Gomez-Hassan</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">S.K.</span> <span class="nlm-surname">Cinti</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Srinivasan</span></span></span></div>
  
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