title: Comparison of fine-needle aspiration and core needle biopsy under ultrasonographic guidance for detecting malignancy and for the tissue-specific diagnosis of salivary gland tumors.
abstract: OBJECTIVE
  Diagnostic test accuracy studies for ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy have shown inconclusive results due to their heterogenous study designs. Our aim was to compare the diagnostic accuracy of ultrasonography-guided fine-needle aspiration versus ultrasonography-guided core needle biopsy for detecting malignant tumors of the salivary gland and for the tissue-specific diagnosis of salivary gland tumors in a single tertiary hospital.
  
  
  METHODS
  This retrospective study was approved by our institutional review board and informed consent was waived. Four hundred twelve patients who underwent ultrasonography-guided fine-needle aspiration (n = 155) or ultrasonography-guided core needle biopsy (n = 257) with subsequent surgical confirmation or clinical follow-up were enrolled. We compared the diagnostic accuracy of ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy regarding malignant salivary gland tumors and the correct tissue-specific diagnosis of benign and malignant tumors. We also tested the difference between these procedures according to the operator's experience and lesion characteristics.
  
  
  RESULTS
  The inconclusive rates of ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy were 19% and 4%, respectively (P < .001). The overall accuracy of ultrasonography-guided core needle biopsy for diagnosing malignant tumors was significantly higher than that of ultrasonography-guided fine-needle aspiration (P = .024). The correct tissue-specific diagnosis rates of ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy were 95% versus 97% for benign tumors (P = .648) and 67% versus 80% for malignant tumors (P = .310). Trainees showed significantly lower accuracy with ultrasonography-guided fine-needle aspiration than with ultrasonography-guided core needle biopsy for diagnosing malignant tumors (P = .021). There was no difference between the diagnostic accuracy of ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy according to the internal composition of the lesions. There were no complications requiring intervention or hospitalization in our patients.
  
  
  CONCLUSIONS
  Ultrasonography-guided core needle biopsy is superior to ultrasonography-guided fine-needle aspiration in detecting and characterizing malignant tumors of the salivary gland and could emerge as the diagnostic method of choice for patients presenting with a salivary gland mass.
authors: From the Department of Radiology and Research Institute of Radiology (H.-J.E., J.H.L., Y.J.C., R.G.Y., J.H.B.).
authors: H-J
authors: HJ
authors: Eom
authors: From the Department of Radiology and Research Institute of Radiology (H.-J.E., J.H.L., Y.J.C., R.G.Y., J.H.B.) jeonghlee@amc.seoul.kr.
authors: J H
authors: JH
authors: Lee
authors: Departments of Health Medicine (M.-S.K.).
authors: M-S
authors: MS
authors: Ko
authors: From the Department of Radiology and Research Institute of Radiology (H.-J.E., J.H.L., Y.J.C., R.G.Y., J.H.B.).
authors: Y J
authors: YJ
authors: Choi
authors: From the Department of Radiology and Research Institute of Radiology (H.-J.E., J.H.L., Y.J.C., R.G.Y., J.H.B.).
authors: R G
authors: RG
authors: Yoon
authors: Pathology (K.J.C.).
authors: K J
authors: KJ
authors: Cho
authors: Otolaryngology (S.Y.N.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: S Y
authors: SY
authors: Nam
authors: From the Department of Radiology and Research Institute of Radiology (H.-J.E., J.H.L., Y.J.C., R.G.Y., J.H.B.).
authors: J H
authors: JH
authors: Baek
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000379:methods; D062005:Biopsy, Large-Core Needle / Q000379:methods*; D002648:Child; D005260:Female; D006801:Humans; D007258:Informed Consent; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012468:Salivary Gland Neoplasms / Q000473:pathology; D012469:Salivary Glands / Q000473:pathology*; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional / Q000379:methods*; D055815:Young Adult