The aim of this study was to analyze the inter- and intra-observer variability regarding biopsy technique in bone and soft tissue sarcoma based on magnetic resonance imaging (MRI).Thirty-seven MRI scans of bone and soft tissue sarcomas treated in our clinic were randomly selected. Six observers with three different expertise levels were assigned to analyze the scans for suspected entity and preferred biopsy technique at 2 time points with a delay of 8 weeks.The differentiation between bone and soft tissue sarcomas in MRI seemed closely related to the observer's level of experience. Regarding biopsy technique, no inter-observer accordance could be identified in either group.We observed an association of inter- and intra-observer agreement regarding suspected tumor entity and the observer's level of experience. The decision for either biopsy technique showed a low inter-observer but high intra-observer variability. These findings suggest that the decision for incisional or core needle biopsy is, even in the expert group, frequently based on personal predilection.
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