title: Small Musculoskeletal Soft-Tissue Lesions: US-guided Core Needle Biopsy--Comparative Study of Diagnostic Yields according to Lesion Size.
abstract: OBJECTIVE
  To determine the effectiveness of ultrasonographically (US) guided core needle biopsy (CNB) for diagnosis of small musculoskeletal soft-tissue lesions by demonstrating the noninferiority of the diagnostic yield with US-guided CNB in lesions measuring 2 cm or smaller to that for lesions larger than 2 cm.
  
  
  METHODS
  This retrospective study was institutional review board approved, and the requirement to obtain informed consent was waived. Five hundred US-guided CNBs performed for diagnosis of musculoskeletal soft-tissue lesions were included. Results of US-guided CNBs were divided into four categories, and the diagnostic yields were calculated on the basis of lesion size. A one-sided 97.5% confidence interval was calculated to determine the mean difference in diagnostic yields to test for noninferiority. In addition, the diagnostic yield with US-guided CNBs for lesions 1 cm or smaller was compared with that for lesions larger than 1 cm.
  
  
  RESULTS
  A total of 500 technically successful US-guided CNBs in 494 patients with musculoskeletal soft-tissue lesions who underwent subsequent surgical excision or at least 6 months of follow-up were included. The diagnostic yields with US-guided CNB were 87% for lesions larger than 2 cm and 88% for lesions 2 cm or smaller. The lower bound of the confidence interval was -0.07, thus the noninferiority of the diagnostic yield with CNB for lesions 2 cm or smaller to that for lesions larger than 2 cm was shown. On the other hand, the diagnostic yield with US-guided CNB for lesions 1 cm or smaller was inferior to that for lesions larger than 1 cm.
  
  
  CONCLUSIONS
  US-guided CNB of musculoskeletal soft-tissue lesions is effective for diagnosis and decision making, even in lesions measuring 2 cm or smaller. However, when a lesion is 1 cm or smaller, US-guided CNB is more frequently insufficient for histopathologic diagnosis.
authors.affiliation: From the Department of Radiology and the Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, Republic of Korea (S.Y.K., H.W.C.); and Department of Radiology, Dankook University Hospital, Cheonan, Republic of Korea (S.Y.K.).
authors.forename: Sang Yoon
authors.initials: SY
authors.lastname: Kim
authors.affiliation: From the Department of Radiology and the Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, Republic of Korea (S.Y.K., H.W.C.); and Department of Radiology, Dankook University Hospital, Cheonan, Republic of Korea (S.Y.K.).
authors.forename: Hye Won
authors.initials: HW
authors.lastname: Chung
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003287:Contrast Media; D006801:Humans; D061705:Image-Guided Biopsy; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000175:diagnosis* / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012983:Soft Tissue Neoplasms / Q000175:diagnosis* / Q000473:pathology; D018084:Ultrasonography, Interventional
chemical_list: D003287:Contrast Media