Awake biopsy in paediatric patients with suspected musculoskeletal malignancy is feasible, cost-effective and reduces time to obtaining tissue

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology Pub Date : 2025-02-13 DOI:10.1016/j.crad.2025.106850

H.R.F. Walters , A. Kothari , M. Mifsud , A. Wainwright , K. Partington

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引用次数: 0

Abstract

Aim

This study aims to evaluate the utility, feasibility, time, and cost-effectiveness of awake ultrasound-guided percutaneous biopsies (AUPBs) in children with suspected musculoskeletal tumours, when compared with more conventional biopsies under general anaesthesia (BGAs).

Materials and Methods

A retrospective analysis of paediatric biopsies performed in a UK tertiary musculoskeletal centre between March 2016 and March 2023 was undertaken. Eighty-six paediatric patients were included in the study, 53 undergoing BGA and 33 undergoing AUPB.

Results

The mean age of patients undergoing AUPB was more than that of patients undergoing BGA at 13.2 years (range: 5-16 years) and 8.5 years (range: 3 months-15 years), respectively. AUPB significantly reduced the time to biopsy, with a mean of 4.7 days (median: 3 days, interquartile range [IQR]: 2-7 days), compared with 11.1 days (median: 5 days, IQR: 2-18 days) for BGAs (P = 0.037). AUPB conferred a one-third reduction in financial cost at £1177 vs £1824 for BGA. Fifty-eight percent patients undergoing AUPB had their biopsy on the same day as their initial assessment in clinic, whilst none of the BGA cases had their biopsy on the same day as their initial assessment in clinic. No complications or procedural abandonment were reported in the AUPB group.

Conclusion

Awake ultrasound-guided biopsy in paediatric musculoskeletal tumours is safe, well tolerated, and cost-effective. It reduces the time to obtain a histological diagnosis compared to BGA. Collaboration between clinicians, radiologists, and play specialists in identifying suitable patients for AUPB can facilitate efficient one-stop clinics and timely diagnosis and reduce costs incurred in paediatric oncological services.

Level of Evidence

Level IV—Diagnostic.

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来源期刊

Clinical radiology 医学-核医学

CiteScore

4.70

自引率

3.80%

发文量

528

审稿时长

76 days

期刊介绍： Clinical Radiology is published by Elsevier on behalf of The Royal College of Radiologists. Clinical Radiology is an International Journal bringing you original research, editorials and review articles on all aspects of diagnostic imaging, including: • Computed tomography • Magnetic resonance imaging • Ultrasonography • Digital radiology • Interventional radiology • Radiography • Nuclear medicine Papers on radiological protection, quality assurance, audit in radiology and matters relating to radiological training and education are also included. In addition, each issue contains correspondence, book reviews and notices of forthcoming events.