Ep. 686 Best Practices for Efficient Bone Marrow Biopsy Procedures with Dr. Mohammad Samim

The very first episode of BackTable was about bone marrow biopsies, and the procedure has come a long way since. Powered drivers, smarter planning, and a well placed periosteal block have made it faster and far more comfortable for patients. On this episode of the BackTable Podcast, Dr. Mohammad Samim, a musculoskeletal radiologist at NYU Langone Health, joins host Dr. Chris Beck to discuss best practices for image-guided bone marrow aspiration and biopsy. They discuss how more referrals are coming from hematology, what drives the need for imaging guidance, and why a careful periosteal block lets most patients avoid sedation. --- Get the BackTable app https://www.backtable.com/app --- This podcast is supported by Varian OmniBone https://cancercare.siemens-healthineers.com/products/interventional-oncology/musculoskeletal/omnibone --- Timestamps 00:00 - Introduction 03:31 - Referral Trends and Procedure Volume 06:15 - Indications and Contraindications 12:28 - Sedation and the Periosteal Block 16:30 - Procedure Walkthrough 23:13 - Powered Access and Variable Speed 29:43 - Sclerotic Bone and Dry Taps 34:55 - Aspiration Pain and On-Site Pathology 37:35 - Sternal Bone Marrow Aspiration 39:07 - Efficiency With Powered Systems 43:37 - Ultrasound Guidance and Workflow 46:45 - Hemodilution and Repeat Biopsies 48:14 - Closing Remarks --- More about this episode The conversation then walks through the procedure itself, from reviewing pelvic anatomy and planning a trajectory on the scout to choosing between a single needle and a coaxial system and aiming for a core close to 1.5 centimeters. Dr. Samim explains how variable speed powered drivers work for both soft and sclerotic bone, what to do when a needle gets stuck or a tap comes back dry, and why a slow, steady pull makes the aspirate less painful. The episode closes with workflow tips for efficiency, minimizing hemodilution, and getting a high-quality sample the first time. --- Resources Increasing Volume of Bone Marrow Biopsies by Radiology Providers: Evaluation of Trends by Physician Specialty and Practice Setting. J Am Coll Radiol. 2020 https://doi.org/10.1016/j.jacr.2020.02.004 BackTable Episode 1, the very first BackTable episode, on bone marrow biopsy, with Dr. Chris Beck, Dr. Aaron Fritts, and Anish Parikh https://www.backtable.com/shows/vi/podcasts/1/bm-bx-devices-jamshidi-vs-oncontrol Dr. Mohammad Samim, NYU Langone Health https://nyulangone.org/doctors/1487966693/mohammad-m-samim Dr. Chris Beck, BackTable contributor page https://www.backtable.com/shows/vi/contributors/dr-christopher-beck --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app