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

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Abstract

Background

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

Objective

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.

Results

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.

Conclusion

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

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Authors and Affiliations

  1. Institut d’Hématologie et d’Oncologie Pédiatriques (IHOPe), 1, place du Pr. Joseph Renault, 69008, Lyon, France

    Antony Ceraulo, Antoine Ouziel & Perrine Marec-Berard

  2. Clinical Research and Innovation Direction (DRCI), Cancer Center Léon Bérard, Lyon, France

    Emilie Lavergne & Lionel Perrier

  3. Department of Pathology, Cancer Center Léon Bérard, Lyon, France

    Anne-Valérie Decouvelaere

  4. Department of Pediatric Orthopedic Surgery, Hospices Civils de Lyon - Hôpital Femme-Mère Enfant, Bron, France

    Franck Chotel

  5. Department of Radiology, Cancer Center Léon Bérard, Lyon, France

    Philippe Thiesse

Authors
  1. Antony Ceraulo
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  2. Antoine Ouziel
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  3. Emilie Lavergne
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  4. Lionel Perrier
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  5. Anne-Valérie Decouvelaere
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  6. Franck Chotel
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  7. Philippe Thiesse
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  8. Perrine Marec-Berard
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Correspondence to Antony Ceraulo.

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Ceraulo, A., Ouziel, A., Lavergne, E. et al. Percutaneous guided biopsy for diagnosing suspected primary malignant bone tumors in pediatric patients: a safe, accurate, and cost-saving procedure. Pediatr Radiol 47, 235–244 (2017). https://doi.org/10.1007/s00247-016-3735-3

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  • DOI: https://doi.org/10.1007/s00247-016-3735-3

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