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

  • Head and Neck
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Abstract

Objectives

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.

Methods

We retrospectively reviewed the records of 6,603 patients with cervical lymphadenopathy who underwent 6695 US-CNB procedures between 2004 and 2017.

Results

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.

Conclusions

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.

Key Points

• 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.

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Abbreviations

FNAC:

Fine-needle aspiration cytology

US-CNB:

Ultrasound-guided core biopsy

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Funding

This study has received funding by the Natural Science Foundation of Guangdong Province, China [Grant Number 2015A030310323].

Author information

Author notes

  1. Feng Han, Min Xu and Ting Xie contributed equally to this work.

Authors and Affiliations

  1. Department of Ultrasound, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong Province, People’s Republic of China

    Feng Han, Min Xu, Jian-Wei Wang, Qing-Guang Lin, Zhi-Xing Guo, Wei Zheng, Jing Han, Xi Lin, Ru-Hai Zou, Jian-Hua Zhou & An-Hua Li

  2. Department of Dermatology, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou, 510120, Guangdong Province, People’s Republic of China

    Ting Xie

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  1. Feng Han
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  2. Min Xu
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Corresponding author

Correspondence to An-Hua Li.

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Guarantor

The scientific guarantor of this publication is An-Hua Li

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

This study was approved by the Institutional Review Board at Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine.

Methodology

• retrospective

• observational

• performed at one institution

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Han, F., Xu, M., Xie, T. et al. Efficacy of ultrasound-guided core needle biopsy in cervical lymphadenopathy: A retrospective study of 6,695 cases. Eur Radiol 28, 1809–1817 (2018). https://doi.org/10.1007/s00330-017-5116-1

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  • DOI: https://doi.org/10.1007/s00330-017-5116-1

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