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Serati L, Morosi C, Barretta F, Collini P, Calareso G, Chiaravalli S, Spreafico F, Luksch R, Ferrari A, Massimino M, Marchianò A. Diagnostic yield and accuracy of image-guided percutaneous core needle biopsy of paediatric solid tumours: An experience from Italy. PEDIATRIC HEMATOLOGY ONCOLOGY JOURNAL 2021. [DOI: 10.1016/j.phoj.2020.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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Avanzini S, Faticato MG, Crocoli A, Virgone C, Viglio C, Severi E, Fagnani AM, Cecchetto G, Riccipetitoni G, Noccioli B, Leva E, Sementa AR, Mattioli G, Inserra A. Comparative retrospective study on the modalities of biopsying peripheral neuroblastic tumors: a report from the Italian Pediatric Surgical Oncology Group (GICOP). Pediatr Blood Cancer 2017; 64. [PMID: 27762097 DOI: 10.1002/pbc.26284] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 09/06/2016] [Accepted: 09/08/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND Peripheral neuroblastic tumors are the most common extracranial solid neoplasms in children. Early and adequate tissue sampling may speed up the diagnostic process and ensure a prompt start of optimal treatment whenever needed. Different biopsy techniques have been described. The purpose of this multi-center study is to evaluate the accuracy and safety of the various examined techniques and to determine whether a preferential procedure exists. METHODS All children who underwent a biopsy, from January 2010 to December 2014, as a result of being diagnosed with a peripheral neuroblastic tumor, were retrospectively reviewed. Data collected included patients' demographics, clinical presentation, intraoperative technical details, postoperative parameters, complications, and histology reports. The Mann-Whitney U and Fisher's exact tests were used for statistical analysis. RESULTS The cohort included 100 patients, 32 of whom underwent an incisional biopsy (performed through open or minimally invasive access) (Group A), and the remaining 68 underwent multiple needle-core biopsies (either imaging-guided or laparoscopy/thoracoscopy-assisted) (Group B). Comparing the two groups revealed that Group A patients had a higher rate of complications, a greater need for postoperative analgesia, and required red blood cell transfusion more often. Overall adequacy rate was 94%, without significant differences between the two groups (100% vs. 91.2% for Group A and Group B, respectively, P = 0.0933). CONCLUSIONS Both incision and needle-core biopsying methods provided sub-optimal to optimal sampling adequacy rates in children affected by peripheral neuroblastic tumors. However, the former method was associated with a higher risk of both intraoperative and postoperative complications compared with the latter.
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Affiliation(s)
| | - Maria Grazia Faticato
- Department of Pediatric Surgery, IRCCS G. Gaslini, Genoa, Italy.,Department of Neuroscience, Rehabilitation, Ophtalmology, Gynecology, and Maternal-Infantile sciences (DINOGMI), University of Genoa, Genoa, Italy
| | - Alessandro Crocoli
- Department of General and Thoracic Surgery, Bambino Gesù Children Hospital-Research Institute, Rome, Italy
| | - Calogero Virgone
- Department of Pediatric Surgery, Padova University Hospital, Padova, Italy
| | - Camilla Viglio
- Department of Pediatric Surgery, Buzzi Hospital, Milan, Italy
| | - Elisa Severi
- Department of Pediatric Surgery, Meyer Children Hospital, Florence, Italy
| | - Anna Maria Fagnani
- Department of Pediatric Surgery, Foundation IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanni Cecchetto
- Department of Pediatric Surgery, Padova University Hospital, Padova, Italy
| | | | - Bruno Noccioli
- Department of Pediatric Surgery, Meyer Children Hospital, Florence, Italy
| | - Ernesto Leva
- Department of Pediatric Surgery, Foundation IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Girolamo Mattioli
- Department of Pediatric Surgery, IRCCS G. Gaslini, Genoa, Italy.,Department of Neuroscience, Rehabilitation, Ophtalmology, Gynecology, and Maternal-Infantile sciences (DINOGMI), University of Genoa, Genoa, Italy
| | - Alessandro Inserra
- Department of General and Thoracic Surgery, Bambino Gesù Children Hospital-Research Institute, Rome, Italy
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Factors influencing the diagnostic yield and accuracy of image-guided percutaneous needle biopsy of pediatric tumors: single-center audit of a 26-year experience. Pediatr Radiol 2016; 46:372-82. [PMID: 26589305 DOI: 10.1007/s00247-015-3484-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 08/16/2015] [Accepted: 10/19/2015] [Indexed: 12/22/2022]
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. MATERIALS AND 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). CONCLUSION 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.
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El Ochi MR, Bellarbi S, Rouas L, Lamalmi N, Malihy A, Alhamany Z, Cherradi N. [Contribution of radio-guided biopsy in the histopathological diagnosis of childhood tumors of: experience of Rabat Child Hospital]. Pan Afr Med J 2015; 21:318. [PMID: 26587165 PMCID: PMC4633739 DOI: 10.11604/pamj.2015.21.318.5657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 08/19/2015] [Indexed: 11/30/2022] Open
Abstract
La biopsie radioguidée constitue une alternative à la biopsie chirurgicale invasive et à la cytologie pour le diagnostic des tumeurs pédiatriques. L'intérêt de notre étude est d’évaluer la valeur diagnostique des biopsies radioguidées examinées au laboratoire d'anatomopathologie de l'hôpital d'Enfants de Rabat (HER). L’étude a porté sur 78 biopsies radioguidées recueillies dans notre laboratoire entre janvier 2008 et décembre 2011. l’âge moyen des patients était de 5 ans et 10 mois avec une prédominance masculine (65,4%). La tumeur était abdominale dans 80% des cas, thoracique dans 15% cas, thoracique et abdominale dans 2,5% et sacrée dans 1,2%. Les biopsies étaient écho-guidées dans 90% des cas et scannoguidées dans 10% des cas. Le diagnostic histopathologique était posé dans 89% des cas. L'immuno-histochimie a été indiquée dans 35% des cas. Les diagnostics les plus fréquents étaient: tumeurs neuroblastiques (42 cas), lymphomes non hodgkiniens (10 cas), rhabdomyosarcomes (6 cas), autres (sarcome d'Ewing, néphroblastomes, tumeur myofibroblastique inflammatoire, maladies de Hodgkin, leucémie aiguë, hépatoblastome et ostéosarcome). Dans notre série, la biopsie radioguidée a permis un diagnostic histopathologique certain dans 89% des cas. Elle nécessite une étroite collaboration entre clinicien, radiologue et anatomopathologiste pour discuter son indication, afin de diminuer le nombre de biopsies peu ou non représentatives.
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Affiliation(s)
- Mohamed Réda El Ochi
- Laboratoire d'Anatomie et de Cytologie Pathologique, Hôpital d'Enfant, Rabat, Maroc
| | - Salma Bellarbi
- Laboratoire d'Anatomie et de Cytologie Pathologique, Hôpital d'Enfant, Rabat, Maroc
| | - Lamiae Rouas
- Laboratoire d'Anatomie et de Cytologie Pathologique, Hôpital d'Enfant, Rabat, Maroc
| | - Najat Lamalmi
- Laboratoire d'Anatomie et de Cytologie Pathologique, Hôpital d'Enfant, Rabat, Maroc
| | - Abderrahmane Malihy
- Laboratoire d'Anatomie et de Cytologie Pathologique, Hôpital d'Enfant, Rabat, Maroc
| | - Zaitouna Alhamany
- Laboratoire d'Anatomie et de Cytologie Pathologique, Hôpital d'Enfant, Rabat, Maroc
| | - Nadia Cherradi
- Laboratoire d'Anatomie et de Cytologie Pathologique, Hôpital d'Enfant, Rabat, Maroc
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Mullassery D, Sharma V, Salim A, Jawaid WB, Pizer BL, Abernethy LJ, Losty PD. Open versus needle biopsy in diagnosing neuroblastoma. J Pediatr Surg 2014; 49:1505-7. [PMID: 25280656 DOI: 10.1016/j.jpedsurg.2014.05.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 03/04/2014] [Accepted: 05/05/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Open surgical biopsy is traditionally advocated prior to initiating therapy in UKCCLG neuroblastoma protocols. We report a single centre experience comparing the utility of open biopsy vs image guided needle biopsy in aiding the definitive diagnosis and risk stratification of neuroblastoma - (Shimada classification, MYCN expression, cytogenetics - 1p 11q, 17 q). METHODS Medical records of all new cases of neuroblastoma presenting to a single UKCCLG centre during January 2002-July 2013 were examined. RESULTS Thirty nine patients underwent a biopsy of primary tumour for neuroblastoma during the study. Twenty one children had open biopsy and eighteen cases had a needle biopsy. Staging of neuroblastoma revealed - stage 4 (n=26), stage 3 (n=7), stage 2 (n=3) and stage 4S (n=3). Sites of primary tumour were adrenal gland (n=20), abdomen (n=12), thoracic (n=4), abdomino-thoracic (n=2) and abdomino pelvic regions (n=1). All patients (open vs needle) had adequate tissue retrieved for histological diagnosis of neuroblastoma. One needle and one open biopsy case did not have MYCN status determined despite adequate tissue sampling. Seventeen patients (7 open and 10 needle biopsies) had 1p and 17q status reported in MLPA testing (Multiplex Ligation-dependent Probe Amplification). No single patient required a repeat tumour biopsy. Morbidity in the series was minimal with only one child - open biopsy group, requiring emergent laparotomy to control bleeding from an abdominal primary tumour. No complications were recorded with needle biopsy. CONCLUSIONS Open and image guided needle biopsy appear to yield adequate tissue sampling for diagnosis, risk classification and staging of neuroblastoma. Further larger co-operative studies may usefully guide national and international protocols.
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Affiliation(s)
- Dhanya Mullassery
- Department of Paediatric Surgery, Alder Hey Children's Hospital NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, UK
| | - Videha Sharma
- Department of Paediatric Surgery, Alder Hey Children's Hospital NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, UK
| | - Adeline Salim
- Department of Paediatric Surgery, Alder Hey Children's Hospital NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, UK
| | - Wajid B Jawaid
- Department of Paediatric Surgery, Alder Hey Children's Hospital NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, UK; Division of Child Health, University of Liverpool, UK
| | - Barry L Pizer
- Department of Medical Oncology, Alder Hey Children's Hospital NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, UK
| | - Laurence J Abernethy
- Department of Radiology, Alder Hey Children's Hospital NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, UK
| | - Paul D Losty
- Department of Paediatric Surgery, Alder Hey Children's Hospital NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, UK; Division of Child Health, University of Liverpool, UK.
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Interventional radiology and the care of the oncology patient. Radiol Res Pract 2011; 2011:160867. [PMID: 22091374 PMCID: PMC3196980 DOI: 10.1155/2011/160867] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2010] [Accepted: 01/27/2011] [Indexed: 12/21/2022] Open
Abstract
Interventional Radiology (IR) is occupying an increasingly prominent role in the care of patients with cancer, with involvement from initial diagnosis, right through to minimally invasive treatment of the malignancy and its complications. Adequate diagnostic samples can be obtained under image guidance by percutaneous biopsy and needle aspiration in an accurate and minimally invasive manner. IR techniques may be used to place central venous access devices with well-established safety and efficacy. Therapeutic applications of IR in the oncology patient include local tumour treatments such as transarterial chemo-embolisation and radiofrequency ablation, as well as management of complications of malignancy such as pain, organ obstruction, and venous thrombosis.
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Bae SH, Han DK, Baek HJ, Park SJ, Chang NK, Kook H, Hwang TJ. Selective embolization of the internal iliac arteries for the treatment of intractable hemorrhage in children with malignancies. KOREAN JOURNAL OF PEDIATRICS 2011; 54:169-75. [PMID: 21738551 PMCID: PMC3127151 DOI: 10.3345/kjp.2011.54.4.169] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Revised: 10/14/2010] [Accepted: 12/29/2010] [Indexed: 11/27/2022]
Abstract
Purpose Acute internal hemorrhage is an occasionally life-threatening complication in pediatric cancer patients. Many therapeutic approaches have been used to control bleeding with various degrees of success. In this study, we evaluated the efficacy of selective internal iliac artery embolization for controlling acute intractable bleeding in children with malignancies. Methods We retrospectively evaluated the cases of 6 children with various malignancies (acute lymphoblastic leukemia, acute myelogenous leukemia, chronic myelogenous leukemia, T-cell prolymphocytic leukemia, Langerhans cell histiocytosis, and rhabdomyosarcoma), who had undergone selective arterial embolization (SAE) of the internal iliac artery at the Chonnam National University Hwasun Hospital between January 2004 and December 2009. SAE was performed by an interventional radiologist using Gelfoam® and/or Tornado® coils. Results The patients were 5 boys and 1 girl with median age of 6.9 years (range, 0.7-14.8 years) at the time of SAE. SAE was performed once in 4 patients and twice in 2, and the procedure was unilateral in 2 and bilateral in 4. The causes of hemorrhage were as follows: hemorrhagic cystitis (HC) in 3 patients, procedure-related internal iliac artery injuries in 2 patients, and tumor rupture in 1 patient. Initial attempt at conservative management was unsuccessful. Of the 6 patients, 5 (83.3%) showed improvement after SAE without complications. Conclusion SAE may be a safe and effective procedure for controlling acute intractable hemorrhage in pediatric malignancy patients. This procedure may obviate the need for surgery, which carries an attendant risk of morbidity and mortality in cancer patients with critical conditions.
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Affiliation(s)
- Sul Hee Bae
- Department of Pediatrics, Chonnam National University Medical School, Gwangju, Korea
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Abstract
As is often the case with developments in interventional radiology (IR), widespread adoption of the newer techniques of interventional oncology has taken longer in paediatric than in adult practice. The three main applications of IR techniques in children with cancer are biopsy, regional therapy and supportive care (including the treatment of complications), and these are considered separately.
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Affiliation(s)
- D J Roebuck
- Department of Radiology, Great Ormond Street Hospital, London, UK.
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Racadio JM. Controlling radiation exposure during interventional procedures in childhood cancer patients. Pediatr Radiol 2009; 39 Suppl 1:S71-3. [PMID: 19083229 DOI: 10.1007/s00247-008-1004-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2008] [Accepted: 08/20/2008] [Indexed: 11/24/2022]
Abstract
Many pediatric cancer patients undergo multiple diagnostic and therapeutic radiologic procedures over the course of their illnesses and are therefore at high risk for radiation exposure. There are a variety of measures that radiologists can employ to reduce this risk. These include limiting the use of radiation whenever possible, using specific strategies to reduce radiation exposure during interventional procedures, using quality assurance programs to ensure compliance, and maintaining continuing staff radiation safety educational programs. Some of the diagnostic and therapeutic interventional radiologic procedures that are performed in pediatric oncology patients are discussed here, along with specific tips for managing radiation exposure.
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Affiliation(s)
- John M Racadio
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
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Anderson P, Kornguth D, Ahrar K, Hughes D, Phan P, Huh W, Cornelius K, Mahajan A. Recurrent, refractory, metastatic and/or unresectable pediatric sarcomas: treatment options for young people ‘off the roadmap’. ACTA ACUST UNITED AC 2008. [DOI: 10.2217/17455111.2.5.605] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Although sarcoma surgery is very important for cancer control, it is not always possible or practical to offer in some situations, including sarcoma recurrences, metastatic disease and/or unacceptable loss of function. We review some pragmatic approaches and examples of how to balance indications, risks and alternatives to control cancer in young people with sarcomas that are no longer using ‘front-line’ therapy. Radiotherapy combined with chemotherapy and outpatient ‘continuation’ chemotherapy regimens using drugs that cause less alopecia can improve function and quality of life. Some effective strategies to help cope when cure is not possible may include tumor ablation techniques performed in interventional radiology and percutaneous nerve blocks. Family centered care and effective problem solving of difficult issues can be greatly facilitated by consultation with a multidisciplinary team experienced in the management of very difficult cases. Treatment of young people with recurrent, relapsed and/or metastatic sarcoma still remains an art very much in the realm of compassion not protocol and persistent advocacy is required for the young person for whom cure may not be possible. A reduction of suffering and assistance in writing more chapters of a rich life narrative is the goal.
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Affiliation(s)
- Pete Anderson
- University of Texas, Department of Pediatrics, Unit 87, MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030-4009, USA
| | - David Kornguth
- University of Texas, Department of Pediatrics, Unit 87, MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030-4009, USA
- Department of Radiation Oncology
| | - Kamran Ahrar
- University of Texas, Department of Pediatrics, Unit 87, MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030-4009, USA
- Department of Diagnostic Radiology
| | - Dennis Hughes
- University of Texas, Department of Pediatrics, Unit 87, MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030-4009, USA
| | - Phil Phan
- University of Texas, Department of Pediatrics, Unit 87, MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030-4009, USA
- Department of Anesthesia & Cancer Pain Service
| | - Winston Huh
- University of Texas, Department of Pediatrics, Unit 87, MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030-4009, USA
| | - Kathleen Cornelius
- University of Texas, Department of Pediatrics, Unit 87, MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030-4009, USA
| | - Anita Mahajan
- University of Texas, Department of Pediatrics, Unit 87, MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030-4009, USA
- Department of Radiation Oncology
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