ArticleEuropean radiology2026
CT-guided bone biopsies with non-diagnostic results in pediatric patients-a multi-institutional 10-year retrospective review.
Article in European radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThis study aimed to determine the diagnostic yield of CT-guided bone biopsies in pediatric patients, the outcome of non-diagnostic CT biopsy results, and to establish factors associated with non-diagnostic biopsy results. MATERIALS AND
methodsThis is a retrospective study of consecutive pediatric patients ≤ 21 years who underwent CT-guided bone biopsies in three tertiary referral hospitals from December 2011 to March 2022. Clinical information, pre-biopsy CT and MRI images, procedural details, pathological results, and follow-up were assessed. Fisher's exact test was used to compare categorical variables. Mann-Whitney U-test and unpaired t-test were used to compare non-parametric and parametric variables, respectively. Statistical significance was set a p < 0.05.
resultsA total of 138 patients (mean age 13.9 ± 4.5 years; 95 (60%) male patients) with 157 CT-guided bone biopsies were studied, which yielded 38.2% (60/157) non-diagnostic, 23.6% (37/157) benign, and 38.2% (60/157) malignant results. Most non-diagnostic lesions (88.3% [53/60]) were subsequently determined to be benign. Factors associated with non-diagnostic biopsy results were cystic lesions (p = 0.003) incidental lesions (p = 0.03), fewer (p = 0.02) and shorter (p = 0.01) tissue cores, non-aggressive radiological features, including narrow zone of transition (p < 0.001), sclerotic margin (p < 0.001), no cortical destruction (p < 0.001), no periosteal reaction (p < 0.001), or no extra-osseous soft tissue mass (p < 0.001).
conclusionAbout one-third of CT-guided bone biopsies in pediatric patients yielded non-diagnostic results, though most were ultimately confirmed to be benign. In children and adolescents with suspected primary bone tumors, CT-guided bone biopsy with non-diagnostic histopathological results strongly favors benignity in lesions with non-aggressive imaging features and should align management towards a more conservative approach. KEY POINTS: Question Limited data exist on the prevalence and outcome of non-diagnostic CT-guided bone biopsy in pediatric patients to guide clinical management. Findings About one-third of CT-guided bone biopsies in pediatric patients were non-diagnostic, though most were ultimately benign. Lesions with non-aggressive features were associated with non-diagnostic results. Clinical relevance In the setting of multidisciplinary care for patients with suspected primary bone tumors, non-diagnostic CT-guided bone biopsy-particularly in lesions with non-aggressive imaging features-strongly favors benignity, which should steer management towards a more conservative approach.
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