Diagnostic performance of PET-CT and technical efficacy of ultrasound-guided core needle biopsy of small and intermediate size malignant supraclavicular lymph nodes

초록

OBJECTIVE: We aimed (1) to determine optimal PET-CT SUV and ultrasound (US) features associated for malignant smallintermediate&#xa0;size supraclavicular lymph nodes (SCN) and (2) to evaluate technical efficacy of core needle biopsy (CNB).&#xa0;Materials and methods: Between 2020 and 2023, CNB of SCN with short-axis less than 15 mm were included. PET-CT was&#xa0;evaluated for optimal SUV cut-off value. Multivariate logistic regression was performed for US features. Technical efficacy of&#xa0;CNB (success rate) was calculated, and US features were compared between satisfactory CNB specimen and unsatisfactory&#xa0;CNB specimen. RESULTS: Eighty-four SCN per 80 patients (age 64.0&#xb1;17.2 years, 45.2% female) were included. The optimal&#xa0;SUV cut-off value was 1.1 with diagnostic accuracy of 89.8%. US features associated with malignancy were anteroposterior&#xa0;dimension &#x2265;9 mm and absence of hilum. The overall CNB success rate was 94%, and unsatisfactory specimen demonstrated&#xa0;shorter transverse diameter (12 mm vs 5 mm, p<0.001), and non-parallel orientation (20.3% vs. 100%, p<0.001). CONCLUSIONS: &#xa0;CNB should be considered for small-intermediate size SCN with SUV exceeding 1.1, anteroposterior dimension &#x2265;9 mm, and&#xa0;absence of hilum. SCN with shorter transverse diameter and non-parallel orientation may result in unsatisfactory CNB specimen.

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