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© 2009 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 28:1679-1684 • 0278-4297

How Diagnostic Is Ultrasound-Guided Neck Mass Biopsy (Fine-Needle Capillary Sampling Biopsy Technique)?

Evaluation of 132 Nonthyroid Neck Mass Biopsies With Pathologic Analysis Over 7 Years at a Single Institution

Edward W. Lee, MD, PhD, Christine Chen, BS, Steven Sauk, MD and Nagesh Ragavendra, MD

Division of Ultrasound Imaging, Department of Radiology, Ronald Reagan Medical Center, University of California, Los Angeles, California USA.

Address correspondence to Nagesh Ragavendra, MD, Division of Ultrasound Imaging, Department of Radiology, Ronald Reagan Medical Center, University of California, 757 Westwood Plaza, Los Angeles, CA 90095 USA. E-mail: nragavendra{at}mednet.ucla.edu

Objective. The purpose of this study was to evaluate the diagnostic value of ultrasound-guided neck mass biopsy (fine-needle capillary sampling biopsy [FNC] technique). Methods. With Institutional Review Board approval, all patients who had an ultrasound-guided neck mass FNC biopsy between January 2000 and December 2006 were retrieved from the ultrasound database. A total of 132 neck mass biopsies were performed in 124 patients. Patient demographics, procedure characteristics, and pathologic diagnoses were recorded. Results. Of the 124 patients, 73 were female (mean age, 51.4 years). Biopsies were performed twice in 8 patients. A significant 200% increase from 2000 through 2002 to 2003 through 2004 and from 2003 through 2004 to 2005 through 2006 was found (P < .05). The most biopsied location was in the lymph nodes (34.8%), followed by perithyroid soft tissue masses (28.0%). A 25-gauge needle was used most frequently (97.7%). A total of 41 biopsies were diagnostic for thyroid diseases (31.1%), with the most common being thyroid papillary carcinoma. We found metastases in 31 biopsies (23.5%). Following these 2 were 29 lymph node biopsies. No major complications were noted. Of the 132 neck masses biopsied, 8 were pathologically nondiagnostic (93.9% diagnostic yield), yielding sensitivity, specificity, and accuracy of greater than 95% (97.1%, 95.2%, and 95.8%, respectively). Conclusions. Ultrasound-guided FNC of neck masses is highly diagnostic. The diagnostic yield is especially high for detection of malignancy, including metastases. Together with a high clinical suspicion, ultrasound-guided needle biopsy should be performed to form a correct diagnosis and make appropriate management plans.

Key Words: fine-needle capillary sampling biopsy • neck mass • nonthyroid • ultrasound guidance

Abbreviations: CT, computed tomography • FNA, fine-needle aspiration biopsy • FNB, fine-needle biopsy • FNC, fine-needle capillary sampling biopsy • MRI, magnetic resonance imaging • PET, positron emission tomography

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Copyright © 2009 by the American Institute of Ultrasound in Medicine.