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This research compares the effectiveness of ultrasound-guided semiautomatic side-cut needles and modified Menghini needles for biopsy of cervical level IV lymph nodes.

March 27, 2026BMC Medical Imaging0 citationsOpen Access

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

GLGang LiuQingdao University YZYixin ZhuPeking University Shenzhen Hospital GWguoru wuPeking University Shenzhen Hospital

Key Points

This research compares the effectiveness of ultrasound-guided semiautomatic side-cut needles and modified Menghini needles for biopsy of cervical level IV lymph nodes.
Retrospective dual-center analysis of 290 patients
Comparison of needle types: US-SABN and US-MMT
Primary endpoint: sample adequacy, secondary endpoints: specimen length, immunohistochemistry use, and complications
Statistical analyses using chi-square and Mann–Whitney U tests.
Sample adequacy was similar for both techniques (US-MMT: 94.9%, US-SABN: 93.0%)
Immunohistochemistry use was comparable (US-MMT: 52.3%, US-SABN: 55.3%)
US-MMT provided longer tissue cores (15.0 mm median) compared to US-SABN (10.0 mm median)
Low complication rates were reported for both techniques (US-MMT: 1.1%, US-SABN: 1.8%)

Abstract

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. 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. 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. 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.

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