Accuracy Of Ultrasound-guided Core Needle Biopsy Research Articles

Accuracy of ultrasound-guided core-needle biopsy confronted with pathological findings and comparison of its costs with vacuum-assisted biopsy’s costs

Introduction: Breast cancer screening has enhanced early–stage diagnosis by detection of impalpable tumors which require histopathological evaluation. Main percutaneous biopsy types are core-needle biopsy (CNB) and vacuum-assisted biopsy (VAB). CNB is less invasive and related to less bleeding and pain. VAB allows larger tissue samples and permits metal clip placement in biopsy bed for posterior localization in case of surgery. Access to VAB is restricted in Brazil due to its high costs. Objectives: To evaluate the agreement between pathological results of ultrasound (US) guided CNB with metal clip placement and surgery and settle false negative rates (FNR), sensibility, specificity, and accuracy of this method, for breast lesions < 20 mm. Methods: 388 US-guided CNB were retrospectively reviewed. Results: Surgical excision was performed in 317 patients. Overall FNR was 9.8%, (5.2% for lesions 10–20 mm), sensibility 90.2% (94.8% for lesions 10–20 mm), specificity 94.9% (94.1% for lesions 10–20 mm), and accuracy 91.1% (94.7% for lesions 10–20 mm). Cost of VAB varies from 2.2 to 12.5 times US-guided CNB. With metal clip placement, VAB costs 1.95 to 5.2 times US-guided CNB. Conclusions: For lesions that can be identified in US, CNB with metal clip placement has high sensitivity, specificity, and accuracy, as well as low FNR.

Accuracy and effectiveness of ultrasound-guided core-needle biopsy in the diagnosis of focal lesions in the salivary glands.

To review the diagnostic accuracy of ultrasound-guided core-needle biopsy (CNB) in the diagnosis of salivary gland tumours (SGT). Retrospective, institutional review board approved, analysis of the CNB of SGT performed at our centre in 8 years. We used an automatic 18-G spring-loaded device. The final diagnosis was based on surgery in the cases that were operated on, and on clinical evolution and biopsy findings in the rest. Four hundred and nine biopsies were performed in 381 patients (ages, 2-97 years; mean, 55.9). There were two minor complications. Biopsy was diagnostic in 98.3%. There were eight false negatives. The diagnostic values for malignancy were: sensitivity 89.6%, specificity 100%, positive predictive value (PPV) 100% and negative predictive value (NPV) 98%. For the detection of neoplasms were: sensitivity 98.7%, specificity 99%, PPV 99.7% and VPN 96.1%. Accuracy of CNB in SGT is very high, with a very high sensitivity and an absolutely reliable diagnosis of malignancy. Complication rate is very low. It should be considered the technique of choice when a STG is detected. Normal tissue results warrant repeating biopsy. • Ultrasound-guided core-biopsy is the technique of choice in salivary glands nodules • Sensitivity, specificity for detecting neoplasms (which should be resected) are around 99% • Diagnosis of malignancy in core-biopsy is absolutely reliable • A CNB result of "normal tissue", however, warrants repeating the biopsy • Complication rate is very low.

Efficacy of ultrasound-guided core needle biopsy in cervical lymphadenopathy: A retrospective study of 6,695 cases

To determine the diagnostic yield of ultrasound-guided core needle biopsy (US-CNB) in cervical lymphadenopathy and identify the factors influencing the diagnostic accuracy of US-CNB. We retrospectively reviewed the records of 6,603 patients with cervical lymphadenopathy who underwent 6695 US-CNB procedures between 2004 and 2017. Adequate specimens were obtained in 92.19 % (6,172/6,695) of cases. Most lymph nodes (67.65 %) were malignant (metastatic carcinoma 4,131; lymphoma 398). The overall accuracy of US-CNB for differentiating benign from malignant lesions was 91.70 % (6,139/6,695). Among biopsies in which adequate material was obtained, the sensitivity, specificity and accuracy of US-CNB were 99.70 %, 100 % and 99.46 %, respectively. The success or failure of US-CNB for the diagnosis of lymphadenopathy was significantly correlated with node size, nature (malignant vs. benign), and location as well as penetration depth, but not with needle size (p = 0.665), number of core tissues obtained (p = 0.324), or history of malignancy (p = 0.060). There were no major procedure-related complications. US-CNB is a safe and effective method of diagnosing cervical lymphadenopathy, and our findings may help optimise the sampling procedure by maximising its diagnostic accuracy and preserving its minimally invasive nature. • US-CNB is useful for the diagnosis of cervical lymphadenopathy. • US-CNB is safe to perform on lymph nodes located near vital structures. • Larger, malignant, level IV lymph nodes yield sufficient tissue samples more easily.

Efficacy of Ultrasound-Guided Core Needle Biopsy in Cervical Lymphadenopathy: A Retrospective Study of 6695 Cases

To determine the diagnostic yield of ultrasound-guided core needle biopsy (US-CNB) in cervical lymphadenopathy and identify the factors influencing the diagnostic accuracy of US-CNB. We retrospectively reviewed the records of 6603 patients with cervical lymphadenopathy who underwent 6695 US-CNB procedures between 2004 and 2017. All the biopsies were performed under real-time US guidance by 1 to 6 passes with a 16 - 20G needle. The final diagnosis was based on histologic examination of excised specimens, clinical course, or laboratory results. Adequate specimens were obtained in 92.19% (6172/6695) of cases. Most lymph nodes (67.65%) were malignant (metastatic carcinoma, 4131; lymphoma, 398). The overall accuracy of US-CNB for differentiating benign from malignant lesions was 91.70% (6139/6695). Among biopsies in which adequate material was obtained, the sensitivity, specificity, and accuracy of US-CNB were 99.70%, 100%, and 99.46%, respectively. The success or failure of US-CNB for the diagnosis of lymphadenopathy was significantly correlated with node size, nature (malignant vs. benign), and location as well as penetration depth, but not with needle size (p = 0.665), number of core tissues obtained (p = 0.324), or history of malignancy (p = 0.060). There were no major procedure-related complications. US-CNB is a safe and effective method of diagnosing cervical lymphadenopathy, and our findings may help optimize the sampling procedure by maximizing its diagnostic accuracy and preserving its minimally invasive nature.

Ultrasound-guided core-needle biopsy in thyroid nodules. A study of 676 consecutive cases with surgical correlation.

To analyze the diagnostic accuracy of ultrasound-guided core-needle biopsy (CNB) of thyroid nodules. Of 3517 CNBs performed using an 18G spring-loaded device in one institution, we retrospectively reviewed 676 nodules in 629 consecutive patients who underwent surgery. CNB and pathological examination were compared. CNB diagnosis was standardized in four categories: insufficient (I), benign (B), follicular lesion (FOL), and malignant (M). Main outcome measures were predictive positive values (PPV), false positives (FP), and false negatives (FN). CNB showed a low rate of insufficient and FOL diagnoses (5.8 % and 4.5 %). On surgery, there were eight FNs in 374 benign CNBs and three FPs in 148 malignant CNBs. The 154 nodules classified as FOL in CNB included, at surgery, 122 neoplasms; 28 of them malignant. PPV for malignancy of a malignant CNB was 98 %, and for a CNB diagnosis of FOL 18.2 %. Sensitivity for malignancy if CNB of FOL and M are considered positive was 95.6. Only one major complication was observed. CNB is reliable, safe, and accurate to evaluate thyroid nodules and can be an alternative technique to FNA. It has low rate of non-diagnostic and undetermined cases, with high sensitivity and PPV. Thyroid core-needle biopsy (CNB) has high sensitivity and PPV. Pitfalls of CNB are rare. Pitfalls are due to cystic cancer, histological heterogeneity, and mistakes in analysis. CNB is a reliable, safe, and accurate method to approach thyroid nodules. CNB can be used primarily or after insufficient or indeterminate FNA.

Comparison of ultrasonographically guided fine‐needle aspiration and core needle biopsy in the diagnosis of parotid masses

To retrospectively compare the accuracies of ultrasound-guided fine-needle aspiration (USFNA) and ultrasound-guided core needle biopsy (USCNB) in the diagnosis of parotid masses. A total of 171 patients (aged 17-86 years, mean 54 years) with parotid masses (35 malignant and 136 benign lesions) underwent either USFNA (n = 107) or USCNB (n = 64). The diagnostic accuracies for differentiating benign from malignant lesions of both examinations were compared. Surgical histopathology (n = 104) and clinical diagnosis (n = 67) were used to establish the final diagnoses. USCNB had a significantly higher sensitivity (94.1%) than USFNA (55.6%) (p < 0.05) in differentiating benign lesions from malignant conditions. The specificity and overall accuracy of USCNB were higher than those of USFNA (100% and 98.4% versus 93.3% and 86.9%, respectively). USCNB provided more specific diagnosis than USFNA (100% versus 93.3%, p < 0.05). All six patients with lymphomas who underwent USCNB were accurately diagnosed, whereas all four patients with lymphomas who underwent USFNA were not. USCNB should be preferred to USFNA when a definite diagnosis of a parotid solid mass is needed.