Diagnostic Yield and Predictive Factors in Ultrasound-Guided Core Needle Biopsy of Soft Tissue Lesions: A Retrospective Study

Objective: To assess the diagnostic adequacy and factors influencing outcomes of ultrasound-guided core needle biopsy (US-CNB) in musculoskeletal soft tissue lesion diagnosis.

Methods: This retrospective study included 222 patients who underwent US-CNB for musculoskeletal soft tissue lesions between June 2020 and June 2023. Patient demographics, lesion characteristics, pre-biopsy imaging findings, needle size, and histopathology results were analyzed. Diagnostic adequacy was defined as alignment with surgical pathology or stability on imaging over 6 months.

Results: The overall diagnostic adequacy rate was 91.0% (202/222). The most common diagnoses were lipoma (20.8%), metastasis (13.9%), and hemangioma (8.4%). No significant association was found between diagnostic adequacy and lesion size, needle gauge, pre-biopsy imaging modality, lesion localization, or history of malignancy (P > .05). Among 32 cases with surgical follow-up, biopsy diagnoses were concordant with surgical pathology in 90.6% of cases. Minor complications occurred in 0.9% of procedures, with no major complications reported.

Conclusion: The US-CNB is a safe and effective diagnostic tool for musculoskeletal soft tissue lesions, achieving high diagnostic adequacy with minimal complications. Its consistent reliability across various lesion types supports its role in guiding patient management. Future research should focus on larger prospective studies to optimize biopsy protocols and further enhance diagnostic accuracy.

Cite this article as: Dablan A, Barut HY, Cingöz M, et al. Diagnostic yield and predictive factors in ultrasound-guided core needle biopsy of soft tissue lesions: A retrospective study. Cerrahpaşa Med J. 2026, 50, 0057, doi:10.5152/cjm.2026.25057.