Ultrasound-guided core-needle biopsy for peripheral pulmonary lesions: a systematic review and meta-analysis

Aim This study aimed to evaluate the diagnostic value and safety of ultrasound (US)-guided core needle biopsy for peripheral pulmonary lesions (PPLs). Materials and Methods We searched PubMed, Embase, and the Cochrane Library for relevant studies published up to June 2022. The diagnostic accuracy of US-guided percutaneous transthoracic needle biopsy (PTNB) for the diagnosis of PPLs was evaluated using pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive and negative likelihood ratios (PLR and NLR), and the area under the summary receiver operating characteristic curves value (SROC). Results Our search included 12 original studies (3830 procedures). For US-guided PTNB, the pooled sensitivity and specificity for the diagnosis of PPLs were 0.93 (95% CI: 0.91-0.94) and 0.99 (95% CI: 0.96-1.00), respectively. The pooled estimates of the PLR, NLR, and DOR were 134.88 (95% CI: 24.88-731.74), 0.07 (95% CI: 0.06-0.09), and 1814.95 (95% CI: 333.62- 9873.76), respectively. The area under the SROC curve was 0.95 (95% CI: 0.93-0.97). The overall complication rate was 3.6% (136 of 3830), including self-limited hemoptysis and asymptomatic pneumothorax, and only 6 cases of pneumothorax requiring chest tube drainage and 1 case of severe bleeding were reported. Conclusions US-guided core needle biopsy is an excellent diagnostic tool for the PPLs, with high accuracy, excellent technical performance and safety.