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

SA Journal of Radiology

Field Value
Title Diagnostic yield and accuracy of paediatric image-guided fine needle aspiration biopsy of deep organ tumours
Creator Bondera, Tichayedza Schubert, Pawel van Zyl, Anel Pitcher, Richard Bagadia, Asif
Subject Interventional radiology; paediatric oncology; cytopathology paediatric; image-guided fine needle aspiration and biopsy (FNAB); rapid on-site evaluation (ROSE); diagnostic yield; diagnostic accuracy; deep organ tumours
Description 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.
Publisher AOSIS
Contributor The research team wishes to thank HREC, the departments of Radiology, Anatomical Pathology, Oncology, Paediatrics and Child Health.
Date 2022-09-28
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Review
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajr.v26i1.2485
Source South African Journal of Radiology; Vol 26, No 1 (2022); 9 pages 2078-6778 1027-202X
Language eng
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https://sajr.org.za/index.php/sajr/article/view/2485/3255 https://sajr.org.za/index.php/sajr/article/view/2485/3256 https://sajr.org.za/index.php/sajr/article/view/2485/3257 https://sajr.org.za/index.php/sajr/article/view/2485/3258
Coverage Africa; South Africa; Western Cape; January 2014 - April 2020 age; sex; clinical diagnosis; anatomical site; radiological characteristics of the lesion; procedural complications; FNAB and ancillary pathological test results; and histopathological diagnosis.
Rights Copyright (c) 2022 Tichayedza Bondera, Pawel Schubert, Anel van Zyl, Richard Pitcher, Asif Bagadia https://creativecommons.org/licenses/by/4.0