title: Ultrasound-guided core biopsy as the primary tool for tissue diagnosis in pediatric oncology.
abstract: BACKGROUND
  Traditionally in pediatric oncology, biopsies were incisional, with a recent alternative of percutaneous imaging-guided biopsies. In our department, ultrasound (US)-guided core biopsy is the first choice for tissue diagnosis in the pediatric population. We retrospectively reviewed our experience and assessed the accuracy rate, safety, and availability of the procedure.
  
  
  METHODS
  Pediatric US-guided biopsies performed in our hospital between November 2003 and November 2011 were studied. Data collection included demographics, clinical and procedural data, and follow-up.
  
  
  RESULTS
  A total of 213 biopsies were performed on 191 patients: 40 known oncologic patients and 173 to establish diagnosis. Seventeen biopsies were excluded, as malignancy was not suspected. Sixty-five percent of the patients had a biopsy within a day. A total of 138 biopsies with tumor at the biopsy site were correctly diagnosed and 4 were missed. Fifty-eight patients were negative for tumor. The sensitivity of our ultrasound-guided core biopsy is 97.1%, specificity 100%, and accuracy 97.9%.We found no complication related to sedation, and 2 procedural complications-bleeding from the biopsy site and seeding of tumor cells-were reported.
  
  
  CONCLUSIONS
  We find US-guided core biopsy for suspected malignancy in the pediatric population to be highly available, safe, and very accurate, having a potential to become the procedure of choice.
authors.affiliation: †Department of Pediatric Surgery ‡Department of Pediatric Oncology, Mayer Children Hospital *Department of Radiology, Rambam Health Care Campus, Haifa, Israel.
authors.forename: Anat
authors.initials: A
authors.lastname: Ilivitzki
authors.forename: Maya
authors.initials: M
authors.lastname: Abugazala
authors.forename: Marc
authors.initials: M
authors.lastname: Arkovitz
authors.forename: Ayelet
authors.initials: A
authors.lastname: Benbarak
authors.forename: Sergey
authors.initials: S
authors.lastname: Postovsky
authors.forename: Nira
authors.initials: N
authors.lastname: Arad-Cohen
authors.forename: Myriam
authors.initials: M
authors.lastname: Ben-Arush
mesh_terms: D000293:Adolescent; D000328:Adult; D001707:Biopsy, Needle; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D061705:Image-Guided Biopsy; D007223:Infant; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D014463:Ultrasonography; D055815:Young Adult