Paige Norwood Misselt MD, Presenter: Nothing to Disclose

Timothy J. Welch MD, Abstract Co-Author: Nothing to Disclose

Doris Ellen Wenger MD, Abstract Co-Author: Nothing to Disclose

Kristen Barry Thomas MD, Abstract Co-Author: Nothing to Disclose

To assess the diagnostic accuracy and complications of image-guided percutaneous biopsy of benign and malignant musculoskeletal lesions in pediatric patients.

An institutional database search yielded 79 pediatric patients with image-guided percutaneous musculoskeletal biopsy over a five year period. Percutaneous biopsy results were first categorized as malignant or benign and then by specific tissue pathology. Additional details including lesion location, biopsy technique, sample size, procedure complications, and patient comorbidities were reviewed. Percutaneous biopsy accuracy was determined by comparison with surgical pathology or based on clinical follow-up. Clinical follow-up was used as an endpoint for lesions deemed benign based on concordance of imaging findings with benign percutaneous biopsy results.

Overall, the diagnostic accuracy in CT or ultrasound-guided biopsies was 86%. Biopsy accuracy was 98% in the assessment of malignant lesions and 76% in the assessment of benign lesions. Mean tissue quantity of diagnostic biopsies was 1.8 cm, while that of non-diagnostic biopsies was 1.2 cm (N=47). The difference in these sample sizes was not statistically significant (p=0.14). The incidence of major complication was 1% (one of 79 patients developed compartment syndrome).       

Image-guided percutaneous biopsy is a safe and accurate method of characterizing musculoskeletal lesions in the pediatric population.  

Image-guided percutaneous biopsy of musculoskeletal lesions in children is safe and accurate as demonstrated by our institutional review of 79 patients.

Misselt, P, Welch, T, Wenger, D, Thomas, K, Image-guided Percutaneous Biopsy of Pediatric Musculoskeletal Lesions.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6007436.html