Image-guided core-needle or surgical biopsy for neuroblastoma diagnosis in children

Infographic · Feb 2024 · 1 min read

In brief

Systematic review comparing image-guided core-needle biopsy versus surgical biopsy for neuroblastoma diagnosis in 490 children. Both techniques achieved similar diagnostic accuracy (90% vs 98%), but image-guided biopsy had significantly fewer complications and lower transfusion rates, supporting its use as preferred diagnostic approach.

Image-guided core-needle biopsy achieves 90% tissue adequacy for neuroblastoma diagnosis, comparable to surgical biopsy (98%, p=.1)
Surgical biopsy has 3.7× higher complication rate (21% vs 6%, p=.005) and 3.7× higher transfusion rate (22% vs 6%, p=.0002)
Both biopsy methods provide similar adequacy for biological characterization (surgical 95% vs image-guided 89%, p=.15)
Image-guided core-needle biopsy should be preferred over surgical biopsy for neuroblastoma workup when feasible
Meta-analysis of 490 patients demonstrates image-guided biopsy is safer with equivalent diagnostic yield for pediatric neuroblastoma

Written by the GCMD Library team from the infographic.

The infographic uses a three-panel layout with a red sidebar on the left containing study metadata. The center panel illustrates the two biopsy techniques with medical icons and anatomical graphics in burgundy and teal colors. The right panel displays three outcome metrics with icons (microscope, hospital bed, blood bag) and percentage comparisons, using burgundy text for the percutaneous approach results.

New infographic by Dr. Jose Campos and the Chilean Society of pediatric surgeons

"Image-guided core-needle or surgical biopsy for neuroblastoma diagnosis in children: A systematic review and meta-analysis from the International Society of Pediatric Surgical Oncology (IPSO)"

Authors: Luca Pio, Hervé J Brisse, Rita Alaggio, Elisa Zambaiti, Jacob Stenman, Stefano Giuliani, Valentina Montano, Alexander Siles Hinojosa, Anders Toel Hoel, Andrea Pevere, Ahmed Abu-Zaid, Stephanie Franchi-Abella, Abdelhafeez H Abdelhafeez, Andrew M Davidoff, Paul D Losty

Full Article: https://gcmd.co/42kahvV

Abstract

Background: Image-guided core-needle biopsy (IGCNB) is a widely used and valuable clinical tool for tissue diagnosis of pediatric neuroblastoma. However, open surgical biopsy remains common practice even if children undergo more invasive and painful procedures. This review aims to determine the diagnostic accuracy and safety of IGCNBs in pediatric patients with neuroblastoma.

Methods: We conducted a systematic review of peer-reviewed original articles published between 1980 and 2023, by searching "pediatric oncology," "biopsy," "interventional radiology," and "neuroblastoma." Exclusion criteria were patients older than 18 years, studies concerning non-neurogenic tumors, case reports, and language other than English. Both the systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

Results: A total of 533 abstracts articles were analyzed. Of these, eight retrospective studies met inclusion criteria (490 infants, 270 surgical biopsies [SB], 220 image-guided biopsies). Tissue adequacy for primary diagnosis (SB: n = 265, 98%; IGCNB: n = 199, 90%; p = .1) and biological characterization (SB: n = 186, 95%; IGCNB: n = 109, 89%; p = .15) was similar with both biopsy techniques, while intraoperative transfusion rate (SB: n = 51, 22%; IGCNB: n = 12, 6%; p = .0002) and complications (%) (SB: n = 58, 21%; IGCNB: n = 14, 6%; p = .005) were higher with surgical biopsy. Length of stay was similar in both groups; however, no additional data about concurrent diagnostic or treatment procedures were available in the analyzed studies.

Conclusions: IGCNB is a safe and effective strategic approach for diagnostic workup of NB and should be considered in preferance to SB wherever possible.

The text in the image

NEUROBLASTOMA BIOPSY: KNIFE OR NEEDLE? | ST. JUDE USA | SYSTEMATIC REVIEW + META-ANALYSIS | 1980 - 2023 | NEUROBLASTOMA | <18 YEARS | 8 RETROSPECTIVE STUDIES | n= 490 | US ASSISTED PERCUTANEOUS BIOPSY | VS | SURGICAL BIOPSY | TISSUE ADEQUACY FOR DIAGNOSIS | 90% vs 98% | p=0.1 | POSTOPERATIVE COMPLICATIONS | 6.4% vs 21.5% | p=0.005 | POSTOPERATIVE TRANSFUSION | 6.3% vs 22.5% | p=<0.001 | Pediatric Blood & Cancer | Pio L, et al.Nov, 2023. DOI: 10.1002/pbc.30789

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