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Background <p>Biopsy of cervical level IV lymph nodes is clinically important but technically challenging because the available needle corridor is often short and adjacent to major cervical vessels. Although core needle biopsy is generally preferred when preserved tissue architecture and ancillary studies are required, ultrasound-guided semiautomatic side-cut needles (US-SABN) and ultrasound-guided modified Menghini needles (US-MMT) have not been directly compared in this anatomically constrained setting.</p> Methods <p>We retrospectively analyzed 290 consecutive patients who underwent ultrasound-guided biopsy of cervical level IV lymph nodes between January 2019 and August 2024 at two tertiary centers. The primary endpoint was sample adequacy. Secondary endpoints included specimen length, use of immunohistochemistry, and procedure-related complications graded according to the CIRSE classification. Categorical variables were compared using Pearson’s chi-square test or Fisher’s exact test, as appropriate, and continuous variables were compared using the Mann–Whitney U test.</p> Results <p>Sample adequacy was similar between US-MMT and US-SABN (94.9% [167/176] vs. 93.0% [106/114]; <i>P</i> = 0.676). Use of immunohistochemistry was also similar (52.3% [92/176] vs. 55.3% [63/114]; <i>P</i> = 0.705). US-MMT yielded longer tissue cores than US-SABN (median, 15.0&#xa0;mm [IQR, 10.0–20.0] vs. 10.0&#xa0;mm [IQR, 7.0–15.0]; <i>P</i> &lt; 0.001). Complication rates were low in both groups (1.1% [2/176] vs. 1.8% [2/114]; <i>P</i> = 0.647), and all complications were minor, self-limited hematomas (CIRSE grade 1). In exploratory within-device analyses, specimen length varied by operator experience.</p> Conclusions <p>US-MMT and US-SABN achieved comparable sample adequacy and low complication rates for biopsy of cervical level IV lymph nodes. Although US-MMT yielded longer tissue cores, this did not translate into differences in sample adequacy, use of immunohistochemistry, or complication rates. Findings from subgroup analyses stratified by operator experience are hypothesis-generating and require prospective validation.</p>

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Comparison of ultrasound-guided biopsy techniques for level IV lymph nodes: semiautomatic vs. Menghini modified needles in a retrospective dual-center study

  • 期刊论文

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  • 发表日期：

    2026年3月25日

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  • Gang Liu,
  • Yixin Zhu,
  • Guoru Wu,
  • Guangyin Yu,
  • Hao Luo,
  • Lu Pang,
  • Qiongxian Long,
  • Lin Zhu,
  • Yu Shi

摘要

Background

Biopsy of cervical level IV lymph nodes is clinically important but technically challenging because the available needle corridor is often short and adjacent to major cervical vessels. Although core needle biopsy is generally preferred when preserved tissue architecture and ancillary studies are required, ultrasound-guided semiautomatic side-cut needles (US-SABN) and ultrasound-guided modified Menghini needles (US-MMT) have not been directly compared in this anatomically constrained setting.

Methods

We retrospectively analyzed 290 consecutive patients who underwent ultrasound-guided biopsy of cervical level IV lymph nodes between January 2019 and August 2024 at two tertiary centers. The primary endpoint was sample adequacy. Secondary endpoints included specimen length, use of immunohistochemistry, and procedure-related complications graded according to the CIRSE classification. Categorical variables were compared using Pearson’s chi-square test or Fisher’s exact test, as appropriate, and continuous variables were compared using the Mann–Whitney U test.

Results

Sample adequacy was similar between US-MMT and US-SABN (94.9% [167/176] vs. 93.0% [106/114]; P = 0.676). Use of immunohistochemistry was also similar (52.3% [92/176] vs. 55.3% [63/114]; P = 0.705). US-MMT yielded longer tissue cores than US-SABN (median, 15.0 mm [IQR, 10.0–20.0] vs. 10.0 mm [IQR, 7.0–15.0]; P < 0.001). Complication rates were low in both groups (1.1% [2/176] vs. 1.8% [2/114]; P = 0.647), and all complications were minor, self-limited hematomas (CIRSE grade 1). In exploratory within-device analyses, specimen length varied by operator experience.

Conclusions

US-MMT and US-SABN achieved comparable sample adequacy and low complication rates for biopsy of cervical level IV lymph nodes. Although US-MMT yielded longer tissue cores, this did not translate into differences in sample adequacy, use of immunohistochemistry, or complication rates. Findings from subgroup analyses stratified by operator experience are hypothesis-generating and require prospective validation.