Factors influencing diagnostic yield in ultrasound-guided omental biopsies: insights from a retrospective study

To evaluate the safety, diagnostic accuracy, and factors influencing the diagnostic yield of ultrasound (US)-guided omental biopsies.

This retrospective study included 109 patients who underwent US-guided omental biopsies between June 2020 and June 2024. Pre-biopsy diagnostic images (CT, MRI, or [18 F]FDG PET/CT) were reviewed. Diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and adverse events were evaluated. Surgical or clinical diagnoses with follow-up served as the diagnostic reference standard. Associations between diagnostic yield and findings on pre-biopsy imaging and biopsy US were explored.

The study achieved a technical success rate of 100%. Initial biopsy results showed a sensitivity of 82.6%, specificity of 100%, PPV of 100%, NPV of 60.5%, and diagnostic accuracy of 86.2%. The pre-biopsy imaging modality was not related to diagnostic accuracy. Ascites interposition on the puncture route was significantly higher in patients without diagnostic accuracy (73.3% vs. 30.9%, p = 0.002). Deeper lesions exhibited lower diagnostic accuracy (p = 0.003). No major or minor complications were associated with the biopsies.

Percutaneous omental biopsy is an effective and safe method for evaluating omental abnormalities. Depth from the needle entry site and the presence of ascites along the puncture route were identified as factors affecting diagnostic accuracy. The choice of imaging modality did not impact diagnostic outcomes, highlighting the importance of lesion-specific factors in the planning of biopsies.