Comparison of accuracy of fine needle aspiration biopsy with and without guidance on soft tissue tumor in a tertiary referral hospital in Indonesia

Introduction: Diagnosing soft tissue tumors is challenging due to the complexity of soft tissue sarcomas, which are malignancies with heterogeneous histological and molecular subtypes, often resulting in delayed diagnoses. The gold standard for examining soft tissue tumors is histopathological examination, which, while definitive, is costly and invasive. Fine Needle Aspiration Biopsy (FNAB) is an alternative method that can be used as an initial screening tool to provide differential diagnoses of soft tissue tumors. FNAB is considered affordable and minimally invasive. Moreover, it can be performed under ultrasonographic (USG) guidance, offering several advantages, including real-time monitoring and visualization during the biopsy. This allows for precise positioning and adjustments to improve sample accuracy. This study aims to demonstrate the advantages of FNAB as a minimally invasive diagnostic tool, evaluate the effectiveness of USG-guided FNAB in assessing soft tissue tumors, and determine the comparative accuracy, sensitivity, specificity, negative predictive value, and positive predictive value of FNAB procedures, both with and without USG-guided.

Methods: The retrospective study with cross-sctional design carried out in Departement of Anatomics Pathology of a tertiary referral hospital in East Java, Indonesia from 2020 to 2022. The diagnostic test measured using a 2x2 table that presents data on the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FNAB with or without USG-guided in diagnosing soft tissue tumors. The results will be compared with the final findings from histopathological or immunohistochemical examinations, which serve as the gold standard for diagnosing soft tissue tumors.

Results: FNAB with USG-guided show the higher accuracy than FNAB without USG-guided. The sensitivity was 83%, specificity of 100%, positive predictive value (PPV) of 100%, negative predictive value (NPV) of 75%, and accuracy of 88.88%.

Conclusion: FNAB can be used as an early diagnostic tool to assess the malignancy of soft tissue tumors. When performed with USG-guided, FNAB demonstrates higher accuracy compared to FNAB without USG-guided.