Employing radiography (X-rays) to localize lesions in human skeletal remains from past populations to allow accurate biopsy, using examples of cancer metastases

Piers D. Mitchell*, Jenna M. Dittmar

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)
4 Downloads (Pure)


Clinical research into biomolecules from infectious diseases and cancers has advanced rapidly in recent years, with two key areas being DNA analysis and proteomics. If we wish to understand important diseases and their associated biomolecules in past populations, techniques are required that will allow accurate biopsy of lesions in excavated human skeletal remains. While locating lesions visible on the surface of a bone is simple, many lesions such as cancer metastases are located in the medulla of bones, unseen on visual inspection. Here, we use two novel image guided techniques to investigate how plain radiographs may improve accuracy in the localization of lesions within bones from medieval individuals. While both techniques were effective, we found the grid technique required fewer radiographs than the pointer technique to employ and so was responsible for a lower overall radiation dose. We then discuss methods available for biopsy in archeological bone and how the optimal location for the biopsy of malignant lesions will vary depending upon whether the tumor is blastic or lytic in nature. Limitations of this X-ray guided approach include that not all cancer metastases are visible on plain radiographs, as erosion of cortical bone is frequently required for visualization of lytic metastases using this imaging modality.

Original languageEnglish
Pages (from-to)916-922
Number of pages7
JournalInternational journal of osteoarchaeology
Issue number4
Early online date11 Jan 2022
Publication statusPublished - 1 Aug 2022

Bibliographical note

This study was funded by the Wellcome Trust (Collaborative Grant 200368/Z/15/Z). Plain radiography was performed by Reveal Imaging Ltd, and Mark Viner supplied the technical information for their equipment. We are grateful to Trish Biers of the Duckworth Collection at the University of Cambridge, Cambridgeshire County Council Historic Environment Team and the Cambridge Archaeological Unit. For the purpose of open access, the author has applied a CC BY public copyright license to any Author Accepted Manuscript version arising from this submission.


  • aDNA
  • biopsy
  • gene mutation
  • imaging
  • malignancy
  • osteoarcheology
  • proteomics
  • radiographs


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