Submission
| Title: | Accuracy of Imaging Compared to Biopsy for Diagnosis of Pediatric Liver Tumors |
| Presenter: | Andrea Wright |
| Institution: | Indiana University School of Medicine |
| Authors: | Andrea Wright Indiana University School of Medicine; Chao Jarasvaraparn Indiana University School of Medicine, Indiana University Division of Pediatric Gastroenterology, Hepatology and Nutrition; Jean Molleston Indiana University School of Medicine, Indiana University Division of Pediatric Gastroenterology, Hepatology and Nutrition |
Abstract
| Background/Significance/Rationale: | Pediatric liver tumors, though uncommon, are the third most frequent type of abdominal tumors in children. These tumors encompass a diverse group of neoplasms, such as hepatoblastoma, hepatocellular carcinoma, focal nodular hyperplasia, hemangiomas, and hepatic abscesses. Pediatric liver tumors etiology often differs from adults, with genetic predispositions and developmental anomalies playing significant roles. Traditionally, diagnosis is made through imaging and tissue sampling; however, technological advancements may reduce the need for tissue sampling through improved imaging accuracy. |
| Methods: | Using DoRIS, an online software tool, 78 patients from 2010-2024 were identified as having a liver biopsy for suspected tumors. Twenty-eight were excluded for not having a liver tumor or not undergoing imaging prior to biopsy, leaving 50 patients. In this retrospective study, imaging reports were compared to biopsy reports to assess diagnostic accuracy. The number and size of lesions were reviewed, and statistical analysis determined if these factors impacted diagnostic accuracy. |
| Results/Findings: | The study included 11 tumors from cancer metastasis, 7 hepatic abscesses, 7 other types of tumors, 6 hepatoblastomas, 6 hepatocellular adenomas, 4 vascular tumors, 2 hepatocellular carcinomas, and 1 rhabdoid tumor. The accuracy using one imaging modality was 73%. CT accuracy was 71%, MRI accuracy was 77%, and ultrasound accuracy was 33%. The average largest lesion size was 55.3 mm, and tumor size did not correlate with imaging accuracy (p=0.8). Overall, 27% showed a different diagnosis between imaging and biopsy. |
| Conclusions/Discussion: | MRI demonstrated the highest accuracy in matching biopsy diagnoses. Tumor size did not impact diagnostic accuracy; rather, accuracy was more likely dependent on the type of tumor. |
| Translational/Human Health Impact: | Biopsy poses risks of pain, bleeding, infection, and hematoma. With research and advancements in imaging, the need for biopsy may be limited to certain types of pediatric liver tumors. |
