Eléonore Blondiaux1, Méryle Laurent2, Etienne Audureau3, Sabah Boudjemaa4, Chiara Sileo2, Marion Lenoir2, Linda Dainese4, Catherine Garel2, Aurore Coulomb4, Hubert Ducou le Pointe2. 1. Department of Radiology, Hôpital Armand-Trousseau-Hôpitaux Universitaires de l'Est Parisien (Assistance Publique - Hôpitaux de Paris), Université Pierre et Marie Curie, Paris, France. eleonore.blondiaux@trs.aphp.fr. 2. Department of Radiology, Hôpital Armand-Trousseau-Hôpitaux Universitaires de l'Est Parisien (Assistance Publique - Hôpitaux de Paris), Université Pierre et Marie Curie, Paris, France. 3. Public Health Department, Hôpital Henri Mondor, Assistance Publique Hôpitaux de Paris, CEpiA EA7376, Université Paris Est Créteil (UPEC), Créteil, France. 4. Department of Pathology, Hôpital Trousseau-Hôpitaux Universitaires de l'Est Parisien (Assistance Publique - Hôpitaux de Paris), Université Pierre et Marie Curie, Paris, France.
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.
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.
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