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Pediatric and Young Adult Image-Guided Percutaneous Bone Biopsy—A New Standard of Care?

  • Pediatric Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

There are no consensus guidelines regarding the use of percutaneous needle biopsy for the diagnosis of soft tissue and bone tumors. The aim of this study was to understand the efficacy of image-guided percutaneous biopsy for pediatric patients with soft tissue and bony masses, the role of intraoperative image guidance, and diagnostic accuracy.

Patients and Methods

A retrospective institutional chart review was performed on patients who underwent percutaneous biopsy of soft tissue or bone tumors between 2007 and 2017. Data collected included preoperative imaging, type of biopsy, demographics, insurance status, number of samples taken, and pathologic results.

Results

One hundred forty-one children and young adults underwent 169 biopsies. Female patients received 48.2% of biopsies. The mean age was 14.3 ± 7.0 years. Core needle biopsies made up 89.4% of procedures, while 10.6% were fine needle aspirate. The mean number of samples per patient was 3.6 ± 2.5. All patients had imaging guidance, with computed tomography used in 44.7% of patients, 9.9% using fluoroscopy, 7.1% using ultrasound for guidance, and 53 (37.6%) patients had more than one modality. Diagnostic specimens were obtained in 97.9% of biopsies. The most common overall pathology was osteoid osteoma. The most common malignant tumors were osteosarcoma and Ewing’s sarcoma.

Conclusion

Image-guided percutaneous biopsy is a safe and effective method of obtaining accurate tissue samples in children and young adults with soft tissue or bone masses.

Level of Evidence

Level 4—Study of diagnostic test

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Funding

Funded by Cincinnati Children’s Hospital Medical Center, Division of Pediatric General and Thoracic Surgery

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Authors and Affiliations

  1. Department of Pediatric General and Thoracic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Jo Cooke-Barber MD, Joseph G. Brungardt MD & Roshni Dasgupta MD, MPH

  2. Department of Orthopedic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Michael Sorger BS & Joel Sorger MD

  3. Department of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Joseph G. Pressey MD, Brian Turpin DO & Rajaram Nagarajan MD

  4. Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Joseph G. Pressey MD

  5. Department of Pathology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Sara Szabo MD

  6. Division of Interventional Radiology, Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Neil Johnson MBBS, M.Med

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  1. Jo Cooke-Barber MD
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Contributions

Jo Cooke-Barber: Co-first author, secondary analysis, manuscript, editing, abstract, and presentation of data. Joseph G. Brungardt: Co-first author, manuscript, editing, abstract, and primary data analysis. Neil Johnson: manuscript review and editing. Michael Sorger: data collection and primary data analysis. Joseph G. Pressey: manuscript review and editing Brian Turpin: manuscript review and editing. Rajaram Nagarajan: manuscript review and editing Sara Szabo: manuscript review and editing. Joel Sorger: manuscript review and editing. Roshni Dasgupta: conceptualization, formal analysis, manuscript review, and editing.

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Correspondence to Roshni Dasgupta MD, MPH.

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Cooke-Barber, J., Brungardt, J.G., Sorger, M. et al. Pediatric and Young Adult Image-Guided Percutaneous Bone Biopsy—A New Standard of Care?. Ann Surg Oncol 30, 3658–3665 (2023). https://doi.org/10.1245/s10434-023-13097-z

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