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

Eur Radiol. 2018 Jul;28(7):2934-2941. doi: 10.1007/s00330-017-5295-9. Epub 2018 Jan 31.

Abstract

Objectives: To review the diagnostic accuracy of ultrasound-guided core-needle biopsy (CNB) in the diagnosis of salivary gland tumours (SGT).

Methods: 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.

Results: 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%.

Conclusions: 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.

Key points: • 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.

Keywords: Biopsy, large-core needle; Image-guided biopsy; Salivary gland neoplasms; Salivary glands; Ultrasonography, interventional.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Large-Core Needle / methods
  • Child
  • Child, Preschool
  • Diagnosis, Differential
  • Female
  • Humans
  • Image-Guided Biopsy / methods
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Retrospective Studies
  • Salivary Gland Neoplasms / diagnostic imaging*
  • Salivary Gland Neoplasms / pathology*
  • Salivary Glands / diagnostic imaging
  • Salivary Glands / pathology
  • Sensitivity and Specificity
  • Ultrasonography, Interventional / methods*
  • Young Adult