Ultrasound-Guided Biopsy Shows High Yield in Pelvic Tumors

A prospective, multicenter cohort study published August 14 in JAMA Network Open found that ultrasonography-guided core needle biopsy produced high diagnostic adequacy and accuracy in selected patients with pelvic tumors. Investigators assessed procedure safety, tissue adequacy, diagnostic accuracy, pain, and overall patient experience.

The study enrolled 461 consecutive adults at 4 high-volume gynecologic oncology centers in Belgium, Italy, the Czech Republic, and Sweden from May 2021 through December 2024. Biopsies were performed on 463 lesions using transvaginal, transrectal, or percutaneous approaches; most procedures took place in an outpatient setting and were performed by trained operators. The primary outcomes were procedure-related complications within 6 weeks and specimen adequacy.

Procedure-related complications occurred in 60 patients (13.0%), and all were classified as minor. No patient required surgery or a blood transfusion because of a complication. After 19 biopsies performed solely for research were excluded, 423 of 442 specimens were diagnostically adequate, corresponding to an adequacy rate of 95.7% (95% CI, 93.4%-97.4%).

Among 166 adequate samples with subsequent surgical histopathologic confirmation, 162 were concordant, for a diagnostic accuracy of 97.6% (95% CI, 93.9%-99.3%). Of 402 participants who answered the experience and pain questions, 378, or 94.0%, rated their overall experience in the upper half of the scale. Median pain during the procedure was 20 on a 0-to-100 scale (IQR, 10-50).

The authors noted that limited use of transrectal and percutaneous approaches may restrict generalizability for those techniques and that clinician assessment of complications could have missed some events. The study also lacked qualitative assessment of patient-reported outcomes. Investigators concluded that ultrasonography-guided core needle biopsy was associated with high diagnostic yield, low complication rates, and favorable patient-reported outcomes in this specialized, multicenter setting.

Source: Timmerman S, Taliento C, Haesen J, et al. Ultrasonography-guided core needle biopsy in the diagnostic pathway of pelvic tumors. JAMA Netw Open. 2026;9(8):e2629587. doi:10.1001/jamanetworkopen.2026.29587