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Percutaneous image-guided needle biopsy in children--summary of our experience with 57 children
M Sklair-Levy1, P D Lebensart, Y H Applbaum
1Department of Radiology, Hadassah University Hospital, P. O.B 12000, Jerusalem, Israel 91120. izhar56@hotmail.com
Insights
Percutaneous image-guided needle biopsy is a safe and effective diagnostic tool for pediatric suspicious masses. This minimally invasive procedure accurately evaluates solid tumors in children, with surgery recommended for non-diagnostic cases.
Area of Science:
- Pediatric Radiology
- Interventional Radiology
- Pediatric Oncology
Background:
- Percutaneous image-guided needle biopsy is standard for adult suspicious masses but less accepted in pediatrics.
- This study addresses the limited pediatric adoption of this diagnostic technique.
Purpose of the Study:
- To evaluate the clinical utility, effectiveness, and limitations of percutaneous image-guided needle biopsy in children.
- To report institutional experience with this procedure in the pediatric population.
Main Methods:
- Performed 69 percutaneous image-guided needle biopsies on 57 children (ages 4 days to 14 years).
- Utilized 16- to-20-gauge cutting-edge needles for core-needle biopsies (62) and fine-needle aspiration biopsies (7).
Main Results:
- Achieved a diagnostic rate of 88.7% (55/69 lesions); 11.3% (7/69) were non-diagnostic, requiring surgery.
- Core-needle biopsy showed 94% diagnostic accuracy for malignant solid tumors (47/50).
- All biopsies were performed without complications, with repeat biopsies yielding diagnostic results.
Conclusions:
- Percutaneous image-guided needle biopsy is a simple, minimally invasive, safe, and accurate method for evaluating pediatric suspicious masses.
- Image-guided needle biopsy is an excellent tool for diagnosing pediatric solid tumors.
- Non-diagnostic biopsies warrant surgical biopsy if clinical suspicion for malignancy remains high.
Background:
Percutaneous image-guided needle biopsy in children has been slower to gain acceptance than in adults where it is regarded as the standard clinical practice in screening suspicious masses.
Objectives:
To report our experience with percutaneous image-guided needle biopsy in the pediatric population and assess its clinical use, efficacy and limitations.
Material And Methods:
Sixty-nine percutaneous image-guided needle biopsies were performed in 57 children. The age of the children ranged from 4 days to 14 years (mean 5.6 years). We used 16- to-20-gauge cutting-edge needles. Sixty-two biopsies were core-needle biopsies and 7 fine-needle aspiration biopsies.
Results:
There were 50 malignant lesions, 10 benign lesions and 2 infectious lesions. In 55 (88.7 %) lesions the needle biopsy was diagnostic. In 7 (11.3 %) the biopsy was non-diagnostic and the diagnosis was made by surgery. Core-needle biopsy was diagnostic in 47 of 50 (94 %) of the malignant solid tumors. In 3 out of 5 children with lymphoma, an accurate diagnosis was obtained with needle aspiration. Seven children underwent a repeated core-needle biopsy, (5 for Wilms' tumor and 2 for neuroblastoma) that was diagnostic in all cases. All the biopsies were performed without complications.
Conclusion:
Percutaneous image-guided needle biopsy is a simple, minimally invasive, safe and accurate method for the evaluation of children with suspicious masses. These data suggest that image-guided needle biopsy is an excellent tool for diagnosing solid tumors in the pediatric population. Negative studies should be considered nondiagnostic and followed by excisional surgical biopsies when clinical suspicion of malignancy is high.
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