Ultrasound guided Core Biopsy with on-site cytology -- immediate
diagnosis in pediatric oncology
Abstract
Background: Accurate and swift tissue diagnosis is extremely important
for the timely initiation of treatment in pediatric oncology. In our
department, ultrasound guided core needle biopsy (US guided CNB) is used
for tissue diagnosis. In 2016, we added on-site cytology, allowing for
an immediate primary diagnosis. We retrospectively reviewed our
performance in terms of safety and accuracy for CNBs and on-site
cytology Procedure: All pediatric biopsies performed in our hospital
between February 2016, and December 2019 were included. Patient
clinical, procedural and follow up data were collected. CNB pathology
and cytology results were compared to final pathologic diagnosis.
Results: We included 185 patients for which 210 biopsies were performed;
Median latency time to biopsy was one day. Altogether, we had 164
tumors, (148 malignant,16 benign) and 46 other lesions. 159 tumors were
correctly diagnosed by CNB; five malignant tumors were misdiagnosed as
benign. The sensitivity of our US guided CNB is 96.7%, specificity
100%, and accuracy 97.6%. On-site cytology was performed in 41 cases;
36 malignant tumors, 2 benign tumors and 3 reactive lymph nodes. The
cytologist correctly differentiated tumor from inflammation in all
cases, and diagnosed the precise tumor type in 38 cases, with accuracy
of 93% for final diagnosis. We had no complications related to the
procedure or sedation. Conclusions: US guided CNB with on-site TI
cytology for suspected malignancy in the pediatric population highly
available, safe and accurate, with real time diagnosis in most cases.
The accelerated diagnostic root has huge impact on patient care.