Abstract
BACKGROUND: Pelvic masses present diagnostic challenges due to their complex origins and non-specific imaging characteristics. The accurate preoperative evaluation of pelvic masses plays a crucial role in guiding clinical decision making. This study sought to compare the efficacy and safety of ultrasound (US)-guided transluminal (transvaginal/transrectal) and transabdominal core needle biopsy (CNB) in the diagnosis of pelvic masses. METHODS: A retrospective cohort study was conducted of 305 patients with pelvic masses, who were divided into the following two groups based on the biopsy approach: the US-guided transabdominal CNB group (the transabdominal group) and the transvaginal/transrectal CNB group (the transluminal group). The biopsy time, intraoperative blood loss, diagnostic accuracy, incidence of complications, and postoperative pain levels were evaluated and compared between the two groups. RESULTS: US-guided biopsy was successfully performed in 305 patients. There were no significant differences between the two groups in terms of accuracy (98.7% vs. 99.3%), biopsy time (98.2±28.7 vs. 94.5±27.7 s, P=0.25), number of puncture needles (2.8±0.7 vs. 2.7±0.8, P=0.61), blood loss (4.3±1.7 vs. 4.6±1.4 mL, P=0.21), or post-puncture visual analogue scale (VAS) score after puncture (2.8±1.2 vs. 2.9±1.2, P=0.52). The long and short diameters of the masses were greater in the transabdominal group (107.5±36.1 mm; 74.7±26.6 mm) than the transluminal group (65.6±37.6 mm; 45.0±23.0 mm; both P<0.001). The diagnostic ability of the transluminal (transvaginal/transrectal) CNB in deep pelvic lesions was better than that of the transabdominal CNB (P<0.001). CONCLUSIONS: US-guided transluminal (transvaginal/transrectal) and transabdominal CNB have comparable diagnostic efficacy and safety for pelvic masses. Transvaginal or transrectal biopsy has substantial clinical value in the evaluation of deep pelvic masses.