Ultrasound-guided core needle biopsy of salivary gland lesions: a systematic review and meta-analysis.

OBJECTIVES/HYPOTHESIS: To obtain summary estimates of the sensitivity and specificity of core needle biopsy for assessment of salivary gland lesions and to investigate sources of variation in accuracy between study locations. STUDY DESIGN: Data sources were PubMed, Embase, CAB Abstracts, CINAHL, BIOSIS, LILACS, PakMediNet, Trip Database, and the National Guideline Clearinghouse. Scopus was used to perform forward (citation) and backward (reference) searches of all potentially relevant studies. METHODS: Screening, data extraction, and quality assessment were independently performed by two different assessors. Meta-analysis was performed using bivariate mixed-effects binary regression as implemented in Stata 12. Quality assessment was performed using the QUADAS-2. RESULTS: The summary estimates of sensitivity and specificity of core needle biopsy for diagnosis of malignancy were 96% (95% confidence interval [CI] = 87-99) and 100% (95% CI = 84-100), respectively. There was no significant heterogeneity in accuracy between studies. The quality of included studies was high, with low risk of verification bias. The risk of hematoma was 1.6% per procedure. CONCLUSIONS: Core needle biopsy has high sensitivity and specificity, and has low risk of complications. There is no significant variation in accuracy between study locations.