European Radiology

, Volume 28, Issue 5, pp 1809–1817 | Cite as

Efficacy of ultrasound-guided core needle biopsy in cervical lymphadenopathy: A retrospective study of 6,695 cases

  • Feng Han
  • Min Xu
  • Ting Xie
  • Jian-Wei Wang
  • Qing-Guang Lin
  • Zhi-Xing Guo
  • Wei Zheng
  • Jing Han
  • Xi Lin
  • Ru-Hai Zou
  • Jian-Hua Zhou
  • An-Hua Li
Head and Neck



To determine the diagnostic yield of ultrasound-guided core needle biopsy (US-CNB) in cervical lymphadenopathy and identify the factors influencing the diagnostic accuracy of US-CNB.


We retrospectively reviewed the records of 6,603 patients with cervical lymphadenopathy who underwent 6695 US-CNB procedures between 2004 and 2017.


Adequate specimens were obtained in 92.19 % (6,172/6,695) of cases. Most lymph nodes (67.65 %) were malignant (metastatic carcinoma 4,131; lymphoma 398). The overall accuracy of US-CNB for differentiating benign from malignant lesions was 91.70 % (6,139/6,695). Among biopsies in which adequate material was obtained, the sensitivity, specificity and accuracy of US-CNB were 99.70 %, 100 % and 99.46 %, respectively. The success or failure of US-CNB for the diagnosis of lymphadenopathy was significantly correlated with node size, nature (malignant vs. benign), and location as well as penetration depth, but not with needle size (p = 0.665), number of core tissues obtained (p = 0.324), or history of malignancy (p = 0.060). There were no major procedure-related complications.


US-CNB is a safe and effective method of diagnosing cervical lymphadenopathy, and our findings may help optimise the sampling procedure by maximising its diagnostic accuracy and preserving its minimally invasive nature.

Key Points

US-CNB is useful for the diagnosis of cervical lymphadenopathy.

US-CNB is safe to perform on lymph nodes located near vital structures.

Larger, malignant, level IV lymph nodes yield sufficient tissue samples more easily.


Ultrasound Core needle biopsy Lymph node Lymphoma Efficacy 



Fine-needle aspiration cytology


Ultrasound-guided core biopsy



This study has received funding by the Natural Science Foundation of Guangdong Province, China [Grant Number 2015A030310323].

Compliance with ethical standards


The scientific guarantor of this publication is An-Hua Li

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

This study was approved by the Institutional Review Board at Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine.


• retrospective

• observational

• performed at one institution


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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  • Feng Han
    • 1
  • Min Xu
    • 1
  • Ting Xie
    • 2
  • Jian-Wei Wang
    • 1
  • Qing-Guang Lin
    • 1
  • Zhi-Xing Guo
    • 1
  • Wei Zheng
    • 1
  • Jing Han
    • 1
  • Xi Lin
    • 1
  • Ru-Hai Zou
    • 1
  • Jian-Hua Zhou
    • 1
  • An-Hua Li
    • 1
  1. 1.Department of Ultrasound, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer MedicineSun Yat-Sen University Cancer CenterGuangzhouPeople’s Republic of China
  2. 2.Department of DermatologyGuangdong Hospital of Traditional Chinese MedicineGuangzhouPeople’s Republic of China

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