Pilot study: Imprint cytology rapidly delivers vertebral lesion diagnosis

CHICAGO — Results of a pilot study presented here indicate the efficacy of implant cytology as a diagnostic test for thoracolumbar vertebral lesions.

“Imprint cytology is a rapid diagnostic test, which adds to our armamentarium as spine surgeons. We have an overall sensitivity of imprint cytology compared to histology of 66.7%, [and a] specificity of 100%,” Manish Chadha, MBBS, MS, of New Delhi, India, said during a presentation at the North American Spine Society Annual Meeting, here.

Chadha prospectively studied both techniques in 30 patients who were suspected of having infective or neoplastic lesions. He analyzed the data from a comparison of implant cytology with histopathology biopsy, which is considered the gold standard, in this case series study.

After investigators gained approval for the study by the hospital ethics board, patients were put under anesthesia and underwent transpedicular biopsy with a Jamshedi needle. At this time, core tissue was also obtained.

The investigators obtained two slides that were stained for imprint cytology. For the histopathology, the core tissue specimens were fixed with formalin and decalcified.

A single cytopathologist who was blinded to the results reviewed the imprint cytology slides and provided a final diagnosis for each patient.

“The time taken to report imprint cytology results was minutes, whereas it took days for the histopathology results, and more for sclerotic lesions,” Chadha said.

The specificity of the imprint cytology compared to histopathology was 100% and the overall accuracy of the new test was 70%, he noted.

The results also showed the positive and negative predictive values of the new method were 100% and 25%, respectively, compared with histopathology.

Two patients studied were suspected of having metastatic disease or infective neoplasm, and both had their diagnoses confirmed by the two tests, according to Chadha. – by Susan M. Rapp

Reference:

Chadha M. Paper #58. Presented at: North American Spine Society Annual Meeting; Oct. 14-17, 2015; Chicago.

Disclosure: Chadha reports no relevant financial disclosures.