Ultrasound-guided core biopsy as the primary tool for tissue diagnosis in pediatric oncology

Traditionally in pediatric oncology, biopsies were incisional, with a recent alternative of percutaneous imaging-guided biopsies. In our department, ultrasound (US)-guided core biopsy is the first choice for tissue diagnosis in the pediatric population. We retrospectively reviewed our experience and assessed the accuracy rate, safety, and availability of the procedure.

Pediatric US-guided biopsies performed in our hospital between November 2003 and November 2011 were studied. Data collection included demographics, clinical and procedural data, and follow-up.

A total of 213 biopsies were performed on 191 patients: 40 known oncologic patients and 173 to establish diagnosis. Seventeen biopsies were excluded, as malignancy was not suspected. Sixty-five percent of the patients had a biopsy within a day. A total of 138 biopsies with tumor at the biopsy site were correctly diagnosed and 4 were missed. Fifty-eight patients were negative for tumor. The sensitivity of our ultrasound-guided core biopsy is 97.1%, specificity 100%, and accuracy 97.9%.We found no complication related to sedation, and 2 procedural complications-bleeding from the biopsy site and seeding of tumor cells-were reported.

We find US-guided core biopsy for suspected malignancy in the pediatric population to be highly available, safe, and very accurate, having a potential to become the procedure of choice.