Post-Test Questions

Article 1 (215-220)

1. Higher diagnostic yield of core needle biopsy in MSK lesions is achieved with:

   • Lytic, large-size, malignant lesions.

   • Single and short specimens.

   • General anesthesia.

   • Local anesthesia.

2. Surgical consultation prior to biopsy of MSK lesions could be required:

   • In the case of bleeding diathesis.

   • In the case of limb-salvage surgery.

   • In the case of vertebral fracture.

   • In the case of infection.

3. Suggested threshold for complications risk in biopsies is:

   • 4%.

   • 5%.

   • 2%.

   • 3%.

   Article 3 (229-237)

4. The greatest challenge to treatment of musculoskeletal malignancy may be expected with:

   • Aggressive tumor biology.

   • Large tumor size.

   • Tumor location near a critical structure.

   • High tumor vascularity.

     E. A combination of the above.

5. IR treatments for musculoskeletal malignancies include:

   • Transarterial embolization.

   • Percutaneous thermal ablation.

   • Vertebral augmentation and cementoplasty.

   • Percutaneous screw fixation.

     E. All of the above.

6. Integrated CT fluoroscopy units improve comprehensive treatment potential by:

   • Increasing radiation dose.

   • Providing functional imaging similar to PET/CT.

   • Affording the means to perform treatment otherwise not feasible by one modality.

   • Afording the option to combine a multistaged treatment into one procedure.

   Article 4 (238-247)

7. Percutaneous ixation by internal cemented screw (FICS)

   • Technique is within the procedural skillset of the interventional radiologist due to translational expertise with minimally invasive procedures and familiarity with highly accurate CT and CBCT guidance methods.

   • Is an open surgical procedure that can only be performed by orthopaedic surgeons.

   • Provides less durability compared to cementoplasty alone to resist tension and torque stresses.

   • Is a new procedure never previously performed by surgeons.

8. When considering percutaneous cement injection during FICS procedure:

   • Cement injection is only indicated if the screw alone does not provide effective palliation.

   • Cement should be injected for better hardware anchorage.

   • Cement injection is only indicated for screws traversing the acetabulum.

   • Cement injection provides no added benefit.

9. Percutaneous FICS for a lytic metastasis of the femoral neck:

   • Is indicated for preventive management if the Mirels score is at least 8.

   • Is optimally performed using only one screw.

   • Is not able to support weight-bearing stresses.

   • Is an effective means for local tumor control.

   Article 8 (268-280)

10. Techniques to improve consolidation of large lytic osseous metastases with extensive cortical erosion includes:

    • Combination of fixation by screw fixation and cement injection.

    • Placement of a stent to guide cement distribution.

    • Creation of a cavity with balloon dilatation.

    • Stepwise approach with viscous cement injected through multiple needles.

    • All of the above.

11. Which complication from vertebral augmentation can result in sequela in the lower extremities?

    • Cement embolism to the periosteal venous plexus.

    • Cement leakage into the disc space.

    • Cement leakage into the aorta.

    • Cement leakage into the back muscles.

12. Anchorage technique for percutaneous cement consolidation describes:

    • Complete consolidative filling of a lytic osseous mass.

    • Focal spot injections around a percutaneous internal screw to prevent screw migration.

    • Combination of cement injection with a locoregional control treatment.

    • A technique performed near tendon insertion sites.