Pediatric Radiology

, Volume 47, Issue 2, pp 235–244 | Cite as

Percutaneous guided biopsy for diagnosing suspected primary malignant bone tumors in pediatric patients: a safe, accurate, and cost-saving procedure

  • Antony Ceraulo
  • Antoine Ouziel
  • Emilie Lavergne
  • Lionel Perrier
  • Anne-Valérie Decouvelaere
  • Franck Chotel
  • Philippe Thiesse
  • Perrine Marec-Berard
Original Article



Percutaneous biopsy is the reference diagnostic procedure for adult musculoskeletal tumors. Its place in pediatrics is controversial and open biopsy remains recommended.


To assess diagnostic performance and feasibility of percutaneous biopsy performed on children and young adults for suspected malignant bone tumors.

Materials and methods

We conducted a 5-year retrospective study including patients ≤21 years who underwent a bone biopsy for a suspected malignant bone tumor. We assessed diagnostic yield (percentage of analyzable biopsies), accuracy (percentage of accurate diagnoses among all analyzable biopsies) and efficacy (percentage of accurate diagnoses among all biopsies), costs, anesthetic requirements and sample availability for biomedical research. Patients diagnosed with an open biopsy were used to compare diagnostic performances, anesthetic requirements and costs.


We included 90 percutaneous and 27 open biopsies in 117 patients. For percutaneous biopsy, diagnostic yield was 95.5% (95% confidence interval [CI] 88.8–98.7%), accuracy was 96.2% (95% CI 86.8–99.5%) and efficacy was 89.3% (95% CI 78.1–96.0%). There was no statistical difference with open biopsy (Fisher exact test, P > 0.05). Mean costs were reduced with percutaneous biopsy: €1,937 (standard deviation [SD] €2,408) versus €6,362 (SD €5,033; Mann-Whitney, P < 0.0001). Thirty-two of the 48 (67%) patients included in clinical trials and diagnosed with percutaneous biopsy had suitable samples for ancillary analyses.


Percutaneous biopsy is a valid alternative to open biopsy for diagnosing pediatric and young adult primary malignant bone tumors.


Accuracy Bone neoplasm Children Cost analysis Fine-needle aspiration Percutaneous core-needle biopsy 


Compliance with ethical standards

Conflicts of interest


Supplementary material

247_2016_3735_MOESM1_ESM.pdf (216 kb)
Online Resource 1 (PDF 215 kb)
247_2016_3735_MOESM2_ESM.pdf (219 kb)
Online Resource 2 (PDF 219 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Institut d’Hématologie et d’Oncologie Pédiatriques (IHOPe)LyonFrance
  2. 2.Clinical Research and Innovation Direction (DRCI)Cancer Center Léon BérardLyonFrance
  3. 3.Department of PathologyCancer Center Léon BérardLyonFrance
  4. 4.Department of Pediatric Orthopedic SurgeryHospices Civils de Lyon - Hôpital Femme-Mère EnfantBronFrance
  5. 5.Department of RadiologyCancer Center Léon BérardLyonFrance

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