title: Factors influencing the diagnostic yield and accuracy of image-guided percutaneous needle biopsy of pediatric tumors: single-center audit of a 26-year experience.
abstract: BACKGROUND
  Image-guided percutaneous core needle biopsy is a common procedure for diagnosis of both solid tumors and hematological malignancies in children. Despite recent improvements, a certain rate of non-diagnostic biopsies persists.
  
  
  OBJECTIVE
  To assess the factors influencing the diagnostic yield and accuracy of percutaneous core needle biopsies of pediatric tumors.
  
  
  METHODS
  We conducted a single-center retrospective study of a 26-year experience with image-guided biopsies in children and young adults. Using uni- and multivariate analysis, we evaluated the association of diagnostic yield and accuracy with technical factors (image-guided procedure, pathological technique) and clinical factors (complication rate, histological type and anatomical location).
  
  
  RESULTS
  We retrieved data relating to 396 biopsies were performed in 363 children and young adults (mean age: 7.4 years). Overall, percutaneous core needle biopsy showed a diagnostic yield of 89.4% (95% confidence interval [CI] 85.9-92.2) and an accuracy of 90.9% (CI 87.6-93.6) with a complication rate of 2.5% (CI 1.2-4.6).The diagnostic yield increased with the use of advanced tissue assessment techniques (95.7% with immunohistochemistry versus 82.3% without immunohistochemistry; P < 0.0001) and an increased number of passes (mean: 3.96 for diagnostic biopsies versus 3.62 for non-diagnostic biopsies; P = 0.044).
  
  
  CONCLUSIONS
  The use of advanced pathological techniques and an increased number of passes are the two main factors influencing the diagnostic success of biopsies in pediatric tumors.
authors.affiliation: Department of Radiology, Hôpital Armand-Trousseau-Hôpitaux Universitaires de l'Est Parisien (Assistance Publique - Hôpitaux de Paris), Université Pierre et Marie Curie, Paris, France. eleonore.blondiaux@trs.aphp.fr.
authors.forename: Eléonore
authors.initials: E
authors.lastname: Blondiaux
authors.affiliation: Department of Radiology, Hôpital Armand-Trousseau-Hôpitaux Universitaires de l'Est Parisien (Assistance Publique - Hôpitaux de Paris), Université Pierre et Marie Curie, Paris, France.
authors.forename: Méryle
authors.initials: M
authors.lastname: Laurent
authors.affiliation: Public Health Department, Hôpital Henri Mondor, Assistance Publique Hôpitaux de Paris, CEpiA EA7376, Université Paris Est Créteil (UPEC), Créteil, France.
authors.forename: Etienne
authors.initials: E
authors.lastname: Audureau
authors.affiliation: Department of Pathology, Hôpital Trousseau-Hôpitaux Universitaires de l'Est Parisien (Assistance Publique - Hôpitaux de Paris), Université Pierre et Marie Curie, Paris, France.
authors.forename: Sabah
authors.initials: S
authors.lastname: Boudjemaa
authors.affiliation: Department of Radiology, Hôpital Armand-Trousseau-Hôpitaux Universitaires de l'Est Parisien (Assistance Publique - Hôpitaux de Paris), Université Pierre et Marie Curie, Paris, France.
authors.forename: Chiara
authors.initials: C
authors.lastname: Sileo
authors.affiliation: Department of Radiology, Hôpital Armand-Trousseau-Hôpitaux Universitaires de l'Est Parisien (Assistance Publique - Hôpitaux de Paris), Université Pierre et Marie Curie, Paris, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Lenoir
authors.affiliation: Department of Pathology, Hôpital Trousseau-Hôpitaux Universitaires de l'Est Parisien (Assistance Publique - Hôpitaux de Paris), Université Pierre et Marie Curie, Paris, France.
authors.forename: Linda
authors.initials: L
authors.lastname: Dainese
authors.affiliation: Department of Radiology, Hôpital Armand-Trousseau-Hôpitaux Universitaires de l'Est Parisien (Assistance Publique - Hôpitaux de Paris), Université Pierre et Marie Curie, Paris, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Garel
authors.affiliation: Department of Pathology, Hôpital Trousseau-Hôpitaux Universitaires de l'Est Parisien (Assistance Publique - Hôpitaux de Paris), Université Pierre et Marie Curie, Paris, France.
authors.forename: Aurore
authors.initials: A
authors.lastname: Coulomb
authors.affiliation: Department of Radiology, Hôpital Armand-Trousseau-Hôpitaux Universitaires de l'Est Parisien (Assistance Publique - Hôpitaux de Paris), Université Pierre et Marie Curie, Paris, France.
authors.forename: Hubert
authors.initials: H
authors.lastname: Ducou le Pointe
mesh_terms: D002648:Child; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D061705:Image-Guided Biopsy / Q000706:statistics & numerical data* / Q000639:trends*; D008297:Male; D008485:Medical Audit; D009369:Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology*; D015995:Prevalence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014600:Utilization Review
keywords: Child; Core needle biopsy; Diagnosis; Image guidance; Neoplasm; Percutaneous biopsy