Accuracy of CT-guided percutaneous core needle biopsy for assessment of pediatric musculoskeletal lesions

Pediatr Radiol. 2011 Jul;41(7):848-57. doi: 10.1007/s00247-010-1970-6. Epub 2011 Jan 18.

Abstract

Background: CT-guided percutaneous core needle biopsy has been shown in adults to be an effective diagnostic tool for a large number of musculoskeletal malignancies.

Objective: To characterize our experience with CT-guided percutaneous core needle biopsy of pediatric bone lesions and determine its utility in diagnosing pediatric osseous lesions, in a population where such lesions are commonly benign.

Materials and methods: From 2000 to 2009, 61 children underwent 63 CT-guided percutaneous biopsies. Radiological, pathological and clinical records were reviewed.

Results: Fourteen biopsies (22%) were performed on malignant lesions, while 49 biopsies (78%) were performed on benign lesions. Forty-nine of the 63 biopsies (78%) were adequate; these children underwent no further tissue sampling. Fourteen of the 63 biopsies (22%) were inadequate or non-conclusive. Of these patients, 12 underwent open biopsy. Retrospective analysis of percutaneous biopsies in these patients demonstrates that 9/12 provided clinically relevant information, and 4/12 patients received final diagnoses that confirmed initial core biopsy findings. No malignancies were diagnosed as benign on percutaneous biopsy. Overall, percutaneous core needle biopsy provided accurate diagnostic information in 84% (53/63) of biopsies.

Conclusion: Our results demonstrate that CT-guided percutaneous biopsy is safe and beneficial in children. This study supports the use of CT-guided percutaneous core needle biopsy for primary diagnosis of pediatric bone lesions.

MeSH terms

  • Adolescent
  • Biopsy, Needle / instrumentation*
  • Bone Neoplasms / diagnostic imaging
  • Bone Neoplasms / pathology*
  • Child
  • Child, Preschool
  • Diagnosis, Differential
  • Equipment Design
  • Female
  • Humans
  • Male
  • Radiography, Interventional / methods*
  • Tomography, X-Ray Computed / methods*