Good morning,
I finally seen my new hemo / oncol doctor yesterday. After several months of getting bounced around. He is not a myeloma specialist. We did the norm MGUS / myeloma labs yesterday. I think I have been walking around for a while on a heel fracture. So we are doing a skeletal survey in the next few weeks. FYI ... most doctors take July off for their vacations. Since I am also bruising a lot more (more then my usual from my bleeding condition).
Well, back to the question. We decided to do a bone marrow biopsy (BMB). He said he does a CT guided one. I never heard of that way. And it sounds scary expensive. Can I ask if anyone else has their BMB done that way. And why?
Thanks for your time.
Forums
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Re: CT guided bone marrow aspiration & core biopsy
Hello Bad Blood,
I didn't have the CT guided bone marrow aspiration and core biopsy that you had, but I did have a CT guided bone biopsy. This was done in February 2011 after I suffered a compression fracture in my T10 vertebrae in December 2010. I was referred to a back surgeon at the time, because they didn't know what else to do with me.
The bone biopsy was a preface to me having a vertebroplasty at the same time, but the intervention radiologist wouldn't perform the vertebroplasty because he said that there was pathology present, meaning a tumor.
It wasn't the most pleasant experience, but I was very doped up on pain meds and further meds administered during the procedure, as I was fully awake. I don't know what the cost was, as my husband always takes care of the bills. We have very good insurance, however.
After that, it was pretty much downhill to my diagnosis of multiple myeloma and further treatment to transplant in November of 2011. I was put on maintenance treatment in May of 2012 and just completed that in June of this year. Keeping my fingers crossed that I stay in remission for many more years before I relapse.
Good luck with your procedure and let us know how it goes.
I didn't have the CT guided bone marrow aspiration and core biopsy that you had, but I did have a CT guided bone biopsy. This was done in February 2011 after I suffered a compression fracture in my T10 vertebrae in December 2010. I was referred to a back surgeon at the time, because they didn't know what else to do with me.
The bone biopsy was a preface to me having a vertebroplasty at the same time, but the intervention radiologist wouldn't perform the vertebroplasty because he said that there was pathology present, meaning a tumor.
It wasn't the most pleasant experience, but I was very doped up on pain meds and further meds administered during the procedure, as I was fully awake. I don't know what the cost was, as my husband always takes care of the bills. We have very good insurance, however.
After that, it was pretty much downhill to my diagnosis of multiple myeloma and further treatment to transplant in November of 2011. I was put on maintenance treatment in May of 2012 and just completed that in June of this year. Keeping my fingers crossed that I stay in remission for many more years before I relapse.
Good luck with your procedure and let us know how it goes.
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Anonymous_Today
Re: Re: CT guided bone marrow aspiration & core biopsy
I forgot to mention, that the reason they did the CT guided biopsy was that they basically had to map to the bone all the nerves as to avoid the nerves that could paralyze you, etc. Makes sense to me.
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Anonymous_Today
Re: CT guided bone marrow aspiration & core biopsy
C. Badiola, F. Scappaticci and D. Brahaj, "CT Guided Bone Marrow Aspiration and Core Biopsy," Open Journal of Radiology, Vol. 2 No. 2, 2012, pp. 55-56
Abstract:
Hemorrhagic complications related to bone marrow aspiration and trephine biopsy are uncommon. Risk factors include thrombocytopenia, myeloproliferative disorders, concurrent use of anticoagulants, and obesity. Here we describe our technique for bone marrow aspiration and biopsy of the posterior iliac crest using CT guidance. Our technique ensures needle passage only through subcutaneous fat and bone, avoiding muscle and neurovascular structures, as well as controlled and precise needle advancement within bone. This technique should be considered for use in patients that are at increased risk for procedure related complications, particularly obese patients, where surface anatomical landmarks may prove unreliable.
http://www.scirp.org/journal/PaperInformation.aspx?paperID=20416 (full text available)
Abstract:
Hemorrhagic complications related to bone marrow aspiration and trephine biopsy are uncommon. Risk factors include thrombocytopenia, myeloproliferative disorders, concurrent use of anticoagulants, and obesity. Here we describe our technique for bone marrow aspiration and biopsy of the posterior iliac crest using CT guidance. Our technique ensures needle passage only through subcutaneous fat and bone, avoiding muscle and neurovascular structures, as well as controlled and precise needle advancement within bone. This technique should be considered for use in patients that are at increased risk for procedure related complications, particularly obese patients, where surface anatomical landmarks may prove unreliable.
http://www.scirp.org/journal/PaperInformation.aspx?paperID=20416 (full text available)
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: CT guided bone marrow aspiration & core biopsy
I underwent a CT guided Biopsy of the inner pelvis ( Superior pole of the Pubis ramii ) for a suspected plasmacytoma in 2012. They went in thru the front. Specifically, Mid-point between the base of the penis and the illiac crest. Gee, I'm kinda happy they just didn't go in "blind". Lots of delicate structures thru there...
So what is your question ?
Do they do it ? Yes.
Why ? ask your MD or follow MultiBilly's cite above.
Hint: Your Bleeding condition.
Good Luck.
So what is your question ?
Do they do it ? Yes.
Why ? ask your MD or follow MultiBilly's cite above.
Hint: Your Bleeding condition.
Good Luck.
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Rneb
Re: CT guided bone marrow aspiration & core biopsy
Thanks for your replies. I am not obese. Yes I am a bleeder, but I have had 2 other BMBs without pain meds or sedation. Had some issues with the desmopression they gave me. Not sure why he wants that done with a CT? Should I request without the CT?
My visit with the doc was yet another disappointing / frustrating talk session. The doc even said to me: You know more about myeloma then I do! O boy! I was scratching my head the whole drive back from the office. My reaction is to run, not walk, away.
My visit with the doc was yet another disappointing / frustrating talk session. The doc even said to me: You know more about myeloma then I do! O boy! I was scratching my head the whole drive back from the office. My reaction is to run, not walk, away.
Re: CT guided bone marrow aspiration & core biopsy
I emailed a nurse; here is their response:
"I have not heard of a CT-guided bone marrow biopsy to assess for myeloma either. Moreover, while the skeletal survey is a standard of care in myeloma, a skeletal survey is not usually the best way to assess early disease. One must have lost about 30% of the bone in order for it to show up on x-ray. If nothing shows up on the x-ray survey, keep in mind that whole-body low-dose CT or whole-body MRI are better assessment tools in early disease, and may show what the x-rays don't. As for your heel, adults do not have bone marrow in their feet, so whatever is fractured in your heel, it was not caused by myeloma."
I cancelled both tests ... waste of $$$
"I have not heard of a CT-guided bone marrow biopsy to assess for myeloma either. Moreover, while the skeletal survey is a standard of care in myeloma, a skeletal survey is not usually the best way to assess early disease. One must have lost about 30% of the bone in order for it to show up on x-ray. If nothing shows up on the x-ray survey, keep in mind that whole-body low-dose CT or whole-body MRI are better assessment tools in early disease, and may show what the x-rays don't. As for your heel, adults do not have bone marrow in their feet, so whatever is fractured in your heel, it was not caused by myeloma."
I cancelled both tests ... waste of $$$
Re: CT guided bone marrow aspiration & core biopsy
Bad blood, run quickly!!!! While it is vital that as patients we are aware of everything to do with myeloma, the doctor should know a lot more. So, as I said run, run, run.
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Guest
Re: CT guided bone marrow aspiration & core biopsy
I wanted to make a correction. After my email with the nurse, I spoke to them, and the CT guided bone marrow biopsy is appropriate for someone like me. The doc is being cautious. I am having it done tomorrow morning. I am sure it will provide a few more pieces of the puzzle. 
9 posts
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