Diagnostic accuracy of ultrasound guided core needle biopsy in parotid gland neoplasms: A retrospective comparative study

Ultrasound-guided Core Needle Biopsies (CNBs) are minimally invasive procedures for diagnosing parotid gland neoplasms, aiming to reduce diagnostic uncertainty and guide management. This study evaluates the efficacy and reliability of CNBs in this context. We retrospectively analyzed 89 patients undergoing 98 CNB procedures. Diagnostic agreement and accuracy were assessed in two distinct subgroups with definitive histological confirmation from resected specimens. The first subgroup evaluated the initial CNB result, while a second subgroup assessed the final conclusive CNB result obtained through the diagnostic pathway. Statistical analyses included Fleiss' and Cohen's kappa coefficients, sensitivity, specificity, and predictive values. The initial CNB had a 7.0 % inconclusive rate. For initial CNB results (N = 40 for accuracy), agreement with histology was moderate (κ = .779), showing 80 % sensitivity and 97.14 % specificity in malignancy assessment. For final conclusive CNB results (N = 42 for accuracy), agreement was strong (κ = .853), demonstrating 100 % sensitivity and 97.37 % specificity. Overall accuracy improved from 95 % to 97.67 % when considering the complete diagnostic pathway. Salivary gland CNBs are a reliable tool for parotid neoplasm diagnosis. While initial attempts may sometimes be inconclusive, the comprehensive CNB diagnostic pathway, including repeat biopsies when necessary, significantly enhances diagnostic accuracy and provides critical guidance for patient management.