# Pediatric and Young Adult Image-Guided Percutaneous Bone Biopsy-A New Standard of Care? — GCMD Library Jo Cooke-Barber, Joseph G Brungardt, Michael Sorger, Joseph G Pressey, Brian Turpin, Rajaram Nagarajan, Sara Szabo, Joel Sorger, Neil Johnson, Roshni Dasgupta

Background: There are no consensus guidelines regarding the use of percutaneous needle biopsy for the diagnosis of soft tissue and bone tumors. The aim of this study was to understand the efficacy of image-guided percutaneous biopsy for pediatric patients with soft tissue and bony masses, the role of intraoperative image guidance, and diagnostic accuracy.

Patients and methods: A retrospective institutional chart review was performed on patients who underwent percutaneous biopsy of soft tissue or bone tumors between 2007 and 2017. Data collected included preoperative imaging, type of biopsy, demographics, insurance status, number of samples taken, and pathologic results.

Results: One hundred forty-one children and young adults underwent 169 biopsies. Female patients received 48.2% of biopsies. The mean age was 14.3 ± 7.0 years. Core needle biopsies made up 89.4% of procedures, while 10.6% were fine needle aspirate. The mean number of samples per patient was 3.6 ± 2.5. All patients had imaging guidance, with computed tomography used in 44.7% of patients, 9.9% using fluoroscopy, 7.1% using ultrasound for guidance, and 53 (37.6%) patients had more than one modality. Diagnostic specimens were obtained in 97.9% of biopsies. The most common overall pathology was osteoid osteoma. The most common malignant tumors were osteosarcoma and Ewing's sarcoma.

Conclusion: Image-guided percutaneous biopsy is a safe and effective method of obtaining accurate tissue samples in children and young adults with soft tissue or bone masses.
Type: video · 1 min · posted 2026-02-20 Canonical: https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545 ## Chapters - [0:00](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545?t=0) Image-Guided Percutaneous Biopsy for Pediatric Bone Tumors ## Statements - "The study evaluated 169 biopsies in 141 patients over a 10-year period at a single institution." — Sophia Schermerhorn (clinical) [0:13](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545?t=13) - "Nearly 90% of the biopsies were core-needle biopsies." — Sophia Schermerhorn (clinical) [0:19](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545?t=19) - "All biopsies were performed with image guidance, most commonly CT, sometimes combined with fluoroscopy and ultrasound." — Sophia Schermerhorn (clinical) [0:22](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545?t=22) - "All biopsies were performed by interventional radiologists." — Sophia Schermerhorn (clinical) [0:28](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545?t=28) - "97.9% of biopsies were diagnostic." — Sophia Schermerhorn (clinical) [0:33](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545?t=33) - "Only 3 patients required repeat biopsy." — Sophia Schermerhorn (clinical) [0:33](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545?t=33) - "There was one patient with transient sciatic nerve paresis, which resolved." — Sophia Schermerhorn (clinical) [0:40](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545?t=40) - "The complication rate was 0.7%." — Sophia Schermerhorn (clinical) [0:43](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545?t=43) - "The approach provided sufficient tissue for histology, immunostains, and molecular studies." — Sophia Schermerhorn (clinical) [0:46](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545?t=46) - "Immunostains and molecular studies are increasingly essential for modern risk stratification and targeted therapy." — Sophia Schermerhorn (clinical) [0:46](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545?t=46) - "Image-guided percutaneous biopsy should be strongly considered the diagnostic modality of choice for pediatric bone and soft tissue tumors." — Sophia Schermerhorn (opinion) [0:56](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545?t=56) ## Transcript Are you still doing open biopsy for pediatric bone tumors? Hi, I'm Doctor Sophia Schermerhorn from Cincinnati Children's, and this study asks whether image-guided percutaneous biopsy should be the new standard of care for pediatric and young adult bone and soft tissue masses. This single institution series evaluated 169 biopsies in 141 patients over a 10-year period. Nearly 90% of these were cornale biopsies. In all were performed with image guidance, most commonly CT, sometimes combined with fluoroscopy and ultrasound as well. All of these biopsies were performed by interventional radiologists. The diagnostic yield was impressive. 97.9% of biopsies were diagnostic, and only 3 patients required repeat biopsy. Additionally, complications were rare. There was just one patient with transient sciatic nerve paresis, which resolved. 0.7% complication rate. Importantly, this approach provided sufficient tissue, not just for histology, but from immunostains and molecular studies, which are increasingly essential for modern risk stratification and targeted therapy. The takeaway image-guided percutaneous biopsy is safe, accurate, and should be strongly considered the diagnostic modality of choice for pediatric bone and soft tissue tumors. --- Not medical advice · citation policy: https://library.globalcastmd.com/ai