낭성 타액선 종양의 수술 전 진단에서 초음파 유도하 세침흡인검사와 비교한 중심바늘생검의 유용성
The Usefulness of Ultrasound-Guided Core Needle Biopsy Compared to Fine Needle Aspiration in Pre-Operative Diagnosis of Cystic-Predominant Parotid Tumors
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Background and Objectives Accurate preoperative prediction of final histopathologic di-agnosis is essential in parotid tumor management, which also includes surgical planning. As apreoperative diagnostic examination for parotid tumors, the accuracy of ultrasound-guidedfine needle aspiration (US-FNA) and ultrasound-guided core needle biopsy (US-CNB) wascompared, and factors affecting the accuracy of diagnosis and adequacy of the specimen wereanalyzed. Subjects and Method This study was conducted as a retrospective analysis of 90 patientswith parotid tumor who had undergone parotidectomy after pre-operative ultrasound-guidedbiopsy. We divided the study subjects into US-FNA and US-CNB groups and evaluated thediagnostic accuracy by comparing the pre-operative results with the final histopathologic di-agnosis after surgery. In addition, accuracy and specimen adequacy were analyzed accordingto tumor components. Results The US-FNA group showed significantly higher rates of non-diagnostic results thanthe US-CNB group (44.0% vs. 13.8%, p=0.002) did. Diagnostic accuracy was also signifi-cantly higher in US-CNB than in US-FNA (95.4% vs. 64.0%, p<0.001), and the non-diagnos-tic result of US-FNA was the main factor in reducing accuracy. Meanwhile, in both cystic-predominant tumors and solid-predominant tumors (94.8% vs. 75%, p=0.023), US-CNBshowed significantly better accuracy than US-FNA (100.0% vs. 20.0%, p=0.010) did. Conclusion US-CNB has superiority in both sample adequacy and diagnostic accuracycompared to US-FNA in preoperative diagnosis of parotid tumors, and it seems necessary toconsider its use more actively in the diagnosis of cystic-predominant tumors.
Abstract
Background and Objectives Accurate preoperative prediction of final histopathologic di-agnosis is essential in parotid tumor management, which also includes surgical planning. As apreoperative diagnostic examination for parotid tumors, the accuracy of ultrasound-guidedfine needle aspiration (US-FNA) and ultrasound-guided core needle biopsy (US-CNB) wascompared, and factors affecting the accuracy of diagnosis and adequacy of the specimen wereanalyzed. Subjects and Method This study was conducted as a retrospective analysis of 90 patientswith parotid tumor who had undergone parotidectomy after pre-operative ultrasound-guidedbiopsy. We divided the study subjects into US-FNA and US-CNB groups and evaluated thediagnostic accuracy by comparing the pre-operative results with the final histopathologic di-agnosis after surgery. In addition, accuracy and specimen adequacy were analyzed accordingto tumor components. Results The US-FNA group showed significantly higher rates of non-diagnostic results thanthe US-CNB group (44.0% vs. 13.8%, p=0.002) did. Diagnostic accuracy was also signifi-cantly higher in US-CNB than in US-FNA (95.4% vs. 64.0%, p<0.001), and the non-diagnos-tic result of US-FNA was the main factor in reducing accuracy. Meanwhile, in both cystic-predominant tumors and solid-predominant tumors (94.8% vs. 75%, p=0.023), US-CNBshowed significantly better accuracy than US-FNA (100.0% vs. 20.0%, p=0.010) did. Conclusion US-CNB has superiority in both sample adequacy and diagnostic accuracycompared to US-FNA in preoperative diagnosis of parotid tumors, and it seems necessary toconsider its use more actively in the diagnosis of cystic-predominant tumors.
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