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

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.

Rapid on‐site evaluation (ROSE) of image‐guided FNA specimens improves subsequent core biopsy adequacy in clinical trial patients: The impact of preanalytical factors and its correlation with survival

“…8 Many studies have also shown the high accuracy, sensitivity, specificity, and positive predictive value of FNA, including deep organs, such as soft tissue, bone, and liver. [9][10][11][12][13][14] Moreover, the use of standardized practices can significantly improve tissue collection, especially for organ-specific recommendations of needle selection, the number of needle passes, and the use of multidisciplinary teams, including radiology, pathology, and oncology. 15 The objectives of this study were to evaluate the role of ROSE in clinical trial-associated small-core biopsy adequacy and to identify continuous and/or categorical predictors of adequacy and cumulative survival.…”

“…It has been well demonstrated that they provide reliable diagnoses comparable to those of cytopathologists as they relate to tissue adequacy 8 . Many studies have also shown the high accuracy, sensitivity, specificity, and positive predictive value of FNA, including deep organs, such as soft tissue, bone, and liver 9–14 . Moreover, the use of standardized practices can significantly improve tissue collection, especially for organ‐specific recommendations of needle selection, the number of needle passes, and the use of multidisciplinary teams, including radiology, pathology, and oncology 15 …”

An Experimental Platform for Tomographic Reconstruction of Tissue Images in Brightfield Microscopy

“…First, sampling of biological material should originate from the most representative region of the pathology. This may be secured, for example, by image-guided biopsy [8,9] using ultrasound or other technologies. Second, the preparation of the material should ensure that the most informative features of the pathology will be visually identifiable when viewed under the microscope.…”