Diagnostic Performance of Ultrasound-guided Percutaneous Biopsy Versus Open Surgical Biopsy In Inflammatory Myopathies.

Authors

Lutof Zreik, Yonit Tavor, Nitai Bar, Polina Stein, Euvgeni Vlodavsky, Yolanda Braun-Moscovici, Daniella Militiano, Natalia Puchkov

Published in

Academic radiology. Jul 14, 2026. Epub Jul 14, 2026.

Abstract

Muscle biopsy remains the diagnostic gold standard for idiopathic inflammatory myopathies (IIM), yet optimal sampling technique is not standardized and open surgical biopsy carries morbidity and hospitalization needs. We evaluated the diagnostic performance, specimen quality, and clinical utility of ultrasound (US)-guided 14-gauge percutaneous biopsy versus open surgical biopsy in patients with suspected IIM.
This single-center retrospective case-control study included consecutive adults undergoing US-guided percutaneous biopsy for suspected myositis from February 2021 - February 2025, and controls undergoing open biopsy from February 2020 - September 2023. Target selection was guided by MRI and pre-procedural US. Primary outcomes were (1) clinical diagnostic yield (diagnostic vs non-diagnostic result, adjudicated by an experienced rheumatologist) and (2) histopathological specimen quality (Likert 1-5, scored by a blinded pathologist), with a predefined non-inferiority margin of 1 point. Secondary outcomes included post-procedure hospitalization duration and complications.
Twenty-one patients underwent percutaneous biopsy and sixteen underwent open biopsy. Diagnostic yield was 95.2% (20/21) for percutaneous biopsy versus 81.3% (13/16) for open biopsy (OR for non-diagnostic result 0.23; 95% CI 0.004-3.16; p=0.29). Mean specimen quality was 3.95 (percutaneous) versus 4.37 (open), meeting non-inferiority (difference -0.42; 95% CI -0.89 to 0.05; p=0.02). Mean post-biopsy hospitalization was 2.48 versus 4.94 days, respectively. Delayed wound healing occurred only after open biopsy (3/16); one post-procedure hematoma occurred in each group.
US-guided 14-gauge percutaneous biopsy provides high diagnostic yield with non-inferior specimen quality compared with open biopsy, while reducing wound complications and shortening hospitalization. Larger prospective multicenter studies are warranted to confirm generalizability.

PMID:
42448483
Bibliographic data and abstract were imported from PubMed on 15 Jul 2026.

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