Ultrasound-guided biopsies have a high yield for tissue diagnosis for lung cancer, regardless of sampling method, according to research published September 11 in Respiratory Medicine.
A team led by Maged Hassan, PhD, from Alexandria University in Egypt, also found that fine-needle aspiration and core biopsy improve the overall yield.
“Combining fine-needle aspiration and core biopsies improves adequacy for extended molecular profiling,” the Hassan team wrote.
Ultrasound-guided sampling of peripheral lesions from the lung, pleura, or metastatic nodes or deposits achieves tissue diagnosis in lung cancer, and with an excellent yield. Radiologists and pulmonologists can perform the procedure.
Fine-needle aspiration and core biopsy are the two sampling methods used in ultrasound-guided biopsy. However, the researchers noted a lack of data comparing the efficacy of both methods.
Hassan and colleagues compared the yield from fine-needle aspiration and core biopsy samples of peripheral lesions sampled under ultrasound guidance in lung cancer patients. They also focused on adequacy for genomic profiling by using multitarget next-generation sequencing.
The study included 66 lung tissue samples. Ultrasound guidance led to a yield of 95.4% for identifying tissue type. The team observed no significant difference in yield between fine-needle aspiration (92.7%) and core biopsy (93.6%).
It also included 32 samples in analysis for multitarget next-generation sequencing, which achieved a success rate of 71.9%. Compared to using either fine-needle aspiration or core biopsy alone, which achieved a success rate of 66.7%, combining both sampling methods led to a 76.5% success rate.
The findings confirm ultrasound-guided biopsy as an effective technique for diagnosing lung cancer, the authors noted, adding that the yield is comparable to that of endobronchial ultrasound-guided samples. They also confirm that sampling via fine-needle aspiration is not inferior to core biopsy in lung cancer, the investigators said.
“The results show an advantage for combined sampling, as opposed to sampling with fine-needle aspiration or core biopsy alone,” they wrote. “This suggests that both sampling techniques should be attempted when feasible to maximize diagnostic and molecular success.”
The team called for prospective studies with standardized protocols to confirm its findings.
Read the full study here.
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
