Pediatric Radiology
March 2016, Volume 46, Issue 3, pp 372-382
Factors influencing the diagnostic yield and accuracy of image-guided percutaneous needle biopsy of pediatric tumors: single-center audit of a 26-year experience
Eléonore Blondiaux , Méryle Laurent, Etienne Audureau, Sabah Boudjemaa
, Chiara Sileo,Marion Lenoir, Linda Dainese
Abstract
Background
Image-guided percutaneous core needle biopsy is a common procedure for diagnosis of both solid tumors and hematological malignancies in children. Despite recent improvements, a certain rate of non-diagnostic biopsies persists.
Objective
To assess the factors influencing the diagnostic yield and accuracy of percutaneous core needle biopsies of pediatric tumors.
Materials and methods
We conducted a single-center retrospective study of a 26-year experience with image-guided biopsies in children and young adults. Using uni- and multivariate analysis, we evaluated the association of diagnostic yield and accuracy with technical factors (image-guided procedure, pathological technique) and clinical factors (complication rate, histological type and anatomical location).
Results
We retrieved data relating to 396 biopsies were performed in 363 children and young adults (mean age: 7.4 years). Overall, percutaneous core needle biopsy showed a diagnostic yield of 89.4% (95% confidence interval [CI] 85.9–92.2) and an accuracy of 90.9% (CI 87.6–93.6) with a complication rate of 2.5% (CI 1.2–4.6).The diagnostic yield increased with the use of advanced tissue assessment techniques (95.7% with immunohistochemistry versus 82.3% without immunohistochemistry; P < 0.0001) and an increased number of passes (mean: 3.96 for diagnostic biopsies versus 3.62 for non-diagnostic biopsies; P = 0.044).
Conclusion
The use of advanced pathological techniques and an increased number of passes are the two main factors influencing the diagnostic success of biopsies in pediatric tumors.