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Background <p>Accurate pathological diagnosis is essential for managing bone lesions suspicious for tumor, including primary tumors and metastases. While CT-guided biopsy is standard, it involves radiation and operational limitations. Ultrasound (US) guidance offers a radiation-free, real-time alternative but is underutilized due to signal attenuation by cortical bone. This study aims to evaluate the diagnostic value of US-guided percutaneous needle biopsy for bone lesions suspicious for tumor and identify key factors influencing its efficacy.</p> Methods <p>A retrospective analysis was conducted on 345 patients with bone lesions suspicious for tumor who underwent US-guided biopsy. Parameters including soft tissue mass visibility and thickness, needle gauge (16-gauge large-bore or 21-gauge fine needle), and number of samples were recorded. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of diagnostic efficacy.</p> Results <p>The overall diagnostic efficacy rate was 83.48%, with 79.55% for primary and 84.82% for metastatic lesions. Multivariate analysis confirmed that visible soft tissue mass (OR = 5.391), mass thickness &gt; 15&#xa0;mm (OR = 5.391), large-bore needle use (OR = 3.287), and ≥ 3 samples (OR = 0.322) were independent predictors of successful diagnosis. ROC analysis showed an AUC of 0.756. Subgroup analysis revealed optimal sampling strategies: ≥4 samples for primary and 3 for metastatic lesions.</p> Conclusion <p>US-guided percutaneous needle biopsy is an effective alternative to CT guidance for bone lesions suspicious for tumor with visible soft tissue masses. Key factors improving diagnostic yield include mass thickness &gt; 15&#xa0;mm, large-bore needles, and adequate sampling. Tailored strategies based on lesion type are recommended to enhance diagnostic accuracy.</p>

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Diagnostic value and related factors of ultrasound-guided percutaneous needle biopsy in bone lesions suspicious for tumor

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月17日

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  • Shasha Xu,
  • Guangli Jiao,
  • Lingyan Zhou

摘要

Background

Accurate pathological diagnosis is essential for managing bone lesions suspicious for tumor, including primary tumors and metastases. While CT-guided biopsy is standard, it involves radiation and operational limitations. Ultrasound (US) guidance offers a radiation-free, real-time alternative but is underutilized due to signal attenuation by cortical bone. This study aims to evaluate the diagnostic value of US-guided percutaneous needle biopsy for bone lesions suspicious for tumor and identify key factors influencing its efficacy.

Methods

A retrospective analysis was conducted on 345 patients with bone lesions suspicious for tumor who underwent US-guided biopsy. Parameters including soft tissue mass visibility and thickness, needle gauge (16-gauge large-bore or 21-gauge fine needle), and number of samples were recorded. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of diagnostic efficacy.

Results

The overall diagnostic efficacy rate was 83.48%, with 79.55% for primary and 84.82% for metastatic lesions. Multivariate analysis confirmed that visible soft tissue mass (OR = 5.391), mass thickness > 15 mm (OR = 5.391), large-bore needle use (OR = 3.287), and ≥ 3 samples (OR = 0.322) were independent predictors of successful diagnosis. ROC analysis showed an AUC of 0.756. Subgroup analysis revealed optimal sampling strategies: ≥4 samples for primary and 3 for metastatic lesions.

Conclusion

US-guided percutaneous needle biopsy is an effective alternative to CT guidance for bone lesions suspicious for tumor with visible soft tissue masses. Key factors improving diagnostic yield include mass thickness > 15 mm, large-bore needles, and adequate sampling. Tailored strategies based on lesion type are recommended to enhance diagnostic accuracy.