Ultrasound-guided core needle biopsy in salivary glands: A meta-analysis

Objectives/hypothesis: Core needle biopsy is an effective diagnostic tool widely used in many oncological diagnostic approaches. It provides an adequate tissue sample for histological evaluation of architecture, which allows tumor grading and classification of malignant and benign tumors. This study aimed to provide an updated meta-analysis and systematic review of core needle biopsy in the salivary glands.

Study design: A literature search using PubMed, Embase, and the Cochrane Library through December 2016.

Methods: Data on true positives, true negatives, false positives, and false negatives were extracted from the relevant articles. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. We calculated accuracy, sensitivity, and specificity with 95% confidence intervals (CIs) using random-effects models that considered both within- and between-study variations.

Results: Our search included 10 observational studies. For core needle biopsy, the sensitivity and specificity for the diagnosis of salivary glands were 0.94 (95% CI: 0.92-0.96, I² = 18.7%, χ² P = .27) and 0.98 (95% CI: 0.97-0.99, I² = 79.6%, χ² P = .00), respectively. The area under the summary receiver operating characteristic curve was 0.98 (95% CI: 0.97-0.99). Seven hematomas, one case of temporary facial paralysis caused by local anesthesia, and no tumor seeding were reported from a total of 1,315 procedures.

Conclusions: Ultrasound core needle biopsy of salivary glands is an excellent diagnostic tool in terms of accuracy, technical performance, and safety profile.

Level of evidence: NA. Laryngoscope, 128:118-125, 2018.