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Imaging effective for pediatric soft tissue, bone mass biopsies

Imaging particularly CT is an effective tool for guiding percutaneous soft tissue and bone mass biopsies in children, according to a study published in the Annals of Surgical Oncology.

In fact, imaging may offer a new standard of care for this indication, wrote a team led by Dr Jo Cooke-Barber of Cincinnati Children’s Hospital Medical Center in Ohio.

“[Our study found that] 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,” the group noted.

No consensus currently exists regarding the use of percutaneous needle biopsy for diagnosis of soft tissue and bone tumors in children, Cooke-Barber and colleagues explained.

“With the advent of next-generation sequencing and gene-targeted chemotherapy protocols, there is an ever-increasing need for tissue samples to facilitate the histopathological and biochemical evaluation of tumors that allows for the use of targeted treatment protocols,” they wrote. “This is especially true for pediatric patients with soft tissue and bone masses.”

The group conducted a chart review study that included 141 children and young adults who underwent 169 biopsies with imaging guidance between 2007 and 2017. Mean age of the study participants was 14, and of the cohort, 48.2% were female. The team tracked factors such as preoperative imaging results, type of biopsy, and number of samples taken; the study’s primary focus was to determine the ability to procure diagnostic-grade specimens.

Most of the biopsies were core needle (89.4%), and the mean number of samples per patient was 3.6. Imaging modalities used were CT (44.7%), fluoroscopy (9.9%), and ultrasound (7.1%); more than a third of the patients underwent more than one type of imaging exam (37.6%).

The majority of biopsy specimens were diagnostic (97.9%), which demonstrated the efficacy of image-guided percutaneous biopsy in a pediatric population, according to the authors.

“The utilization of percutaneous, rather than open, [imaging-guided] core needle biopsy with at least three to four core samples, for the diagnosis of soft tissue and bone masses is a safe and

effective method of obtaining accurate tissue samples for diagnosis, and should be considered as the diagnostic modality of choice,” they concluded. AuntMinnie

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