Diagnostic yield and accuracy of paediatric image-guided fine needle aspiration biopsy of deep organ tumours.

Pub Date : 2022-09-28 eCollection Date: 2022-01-01 DOI:10.4102/sajr.v26i1.2485
Tichayedza Bondera, Pawel Schubert, Anel van Zyl, Richard Pitcher, Asif Bagadia
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引用次数: 2

Abstract

Background: Paediatric tumour cytological diagnosis by image-guided fine needle aspiration biopsy (FNAB) with rapid on-site evaluation (ROSE) has not gained wide acceptance despite increasing publications advocating the procedure.

Objective: The primary aim was an audit of the diagnostic yield and accuracy of paediatric image-guided FNAB with ROSE at a single institution. Evaluation of safety was a secondary aim.

Method: Details of consecutive cases of paediatric image-guided FNAB with ROSE for suspected non-benign deep-seated lesions performed from 01 January 2014 to 30 April 2020 were retrieved from the institutional radiology and laboratory databases. Diagnostic yield and accuracy were evaluated using clinico-pathological-radiological correlation and/or subsequent histological specimen diagnosis correlation. Complications and the frequency of key radiological features potentially affecting yield and accuracy were described.

Results: Of 65 cases retrieved, cytology showed malignancy in 52, benign features in five and one indeterminate diagnosis; seven samples were insufficient for cytological assessment. Of the 65 cases, 58 had subsequent formal histological diagnosis. The overall diagnostic yield was 98.5%, with 94.5% sensitivity, 100.0% specificity, 100.0% positive predictive value, 75.0% negative predictive value and 95.3% diagnostic accuracy. All cases (n = 26) demonstrating restricted diffusion on MRI yielded adequate samples and cyto-histopathological correlation.

Conclusion: Paediatric image-guided FNAB with ROSE has a relatively high diagnostic yield, sensitivity, specificity, positive predictive value and accuracy in the diagnosis of deep-seated tumours. The relatively low negative predictive value may reflect insufficient samples obtained from cystic and/or benign lesions. Sampling from areas of restricted MRI diffusion may enhance diagnostic yield.

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影像引导下小儿深部器官肿瘤细针穿刺活检的诊断率和准确性。
背景:尽管越来越多的出版物提倡采用图像引导的细针穿刺活检(FNAB)和快速现场评估(ROSE)进行儿科肿瘤细胞学诊断,但该方法尚未得到广泛接受。目的:主要目的是审计单一机构的儿童图像引导FNAB与ROSE的诊断产量和准确性。安全性评价是次要目标。方法:从2014年1月1日至2020年4月30日,从机构放射学和实验室数据库中检索疑似非良性深部病变的连续儿科图像引导FNAB合并ROSE病例的详细信息。通过临床-病理-放射学相关性和/或随后的组织学标本诊断相关性评估诊断的产出率和准确性。描述了并发症和可能影响产出率和准确性的关键放射特征的频率。结果:本组65例中,细胞学检查显示恶性52例,良性5例,诊断不明确1例;7份样本不足以进行细胞学评估。在65例病例中,58例随后进行了正式的组织学诊断。总诊断率为98.5%,其中敏感性94.5%,特异性100.0%,阳性预测值100.0%,阴性预测值75.0%,诊断准确率95.3%。所有在MRI上显示扩散受限的病例(n = 26)均获得了足够的样本和细胞-组织病理学相关性。结论:儿童影像引导下FNAB联合ROSE对深部肿瘤诊断具有较高的诊断率、敏感性、特异性、阳性预测值和准确性。相对较低的阴性预测值可能反映了从囊性和/或良性病变中获得的样本不足。从MRI扩散受限的区域取样可提高诊断率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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