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

To evaluate the diagnostic value and safety of ultrasound-guided core-needle biopsy for peripheral pulmonary lesions (PPLs). PubMed, EMBASE, and the Cochrane Library for relevant were searched for 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). The search included 12 original studies (3,830 procedures). For US-guided PTNB, the pooled sensitivity and specificity for the diagnosis of PPLs were 0.93 (95% confidence interval [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 1,814.95 (95% CI: 333.62–9,873.76), 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 3,830), including self-limited haemoptysis and asymptomatic pneumothorax, and only six cases of pneumothorax requiring chest tube drainage and one case of severe bleeding were reported. US-guided core-needle biopsy is an excellent diagnostic tool for PPLs, with high accuracy and excellent technical performance and safety. •Ultrasound-guided core needle biopsy shows high accuracy for PPLs.•Pooled sensitivity and specificity of ultrasound-guided PTNB for PPLs were high.•The procedure has a low overall complication rate of 3.6%.