Pediatric and Young Adult Image-Guided Percutaneous Bone Biopsy-A New Standard of Care?
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- Image-guided percutaneous biopsy achieved 97.9% diagnostic yield in 169 pediatric bone/soft tissue biopsies with only 0.7% complication rate
- Percutaneous technique provided sufficient tissue for histology, immunostains, and molecular studies needed for modern risk stratification
- Only 3 of 141 patients required repeat biopsy, demonstrating high first-pass success rate with interventional radiology approach
- CT-guided core needle biopsy should be considered first-line over open biopsy for pediatric and young adult bone tumors
- Single transient sciatic nerve paresis was the only complication in 169 procedures, supporting safety profile in experienced hands
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Are you still doing open biopsy for pediatric bone tumors? Hi, I'm Doctor Sophia Schermerhorn from Cincinnati Children's, and this study asks whether image-guided percutaneous biopsy should be the new standard of care for pediatric and young adult bone and soft tissue masses. This single institution series evaluated 169 biopsies in 141 patients over a 10-year period. Nearly 90% of these were cornale biopsies. In all were performed with image guidance, most commonly CT, sometimes combined with fluoroscopy and ultrasound as well. All of these biopsies were performed by interventional radiologists. The diagnostic yield was impressive. 97.9% of biopsies were diagnostic, and only 3 patients required repeat biopsy. Additionally, complications were rare. There was just one patient with transient sciatic nerve paresis, which resolved. 0.7% complication rate. Importantly, this approach provided sufficient tissue, not just for histology, but from immunostains and molecular studies, which are increasingly essential for modern risk stratification and targeted therapy. The takeaway image-guided percutaneous biopsy is safe, accurate, and should be strongly considered the diagnostic modality of choice for pediatric bone and soft tissue tumors.