Clinical Epidemiology and Ageing

Factors influencing the diagnostic yield and accuracy of image-guided percutaneous needle biopsy of pediatric tumors: single-center audit of a 26-year experience.

Blondiaux E, Laurent M, Audureau E, Boudjemaa S, Sileo C, Lenoir M, Dainese L, Garel C, Coulomb A, le Pointe HDucou Pediatr Radiol. 2016;46(3):372-82.

<p><b>BACKGROUND: </b>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.</p><p><b>OBJECTIVE: </b>To assess the factors influencing the diagnostic yield and accuracy of percutaneous core needle biopsies of pediatric tumors.</p><p><b>MATERIALS AND METHODS: </b>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).</p><p><b>RESULTS: </b>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).</p><p><b>CONCLUSION: </b>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.</p>

MeSH terms: Child; Female; France; Humans; Image-Guided Biopsy; Male; Medical Audit; Neoplasms; Prevalence; Reproducibility of Results; Sensitivity and Specificity; Utilization Review
DOI: 10.1007/s00247-015-3484-8