Evaluating the Diagnostic Accuracy of Ultrasound-Guided Omental Biopsy in Relation to Pre-Biopsy Computed Tomography Imaging

To evaluate the diagnostic accuracy and safety of ultrasound (US)-guided omental biopsy in patients with omental involvement, and to assess the added value of pre-biopsy computed tomography (CT). This retrospective study included 75 patients who underwent US-guided omental biopsy between January 2023 and 2025. Demographics, clinical, surgical pathology, and cytology data of patients were reviewed. The Mann-Whitney U test and Pearson χ2 test were used to compare the benign and malignant groups as well as diagnostic and non-diagnostic groups. Diagnostic accuracy, sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) were calculated using final diagnoses. Among the 75 patients [median age: 69 y (range: 28 to 87); 81% women], 70 had malignant and 5 had benign final diagnoses. US-guided omental biopsy achieved a diagnostic accuracy of 90.67%, with a sensitivity of 90%, specificity of 100%, NPV of 41.67%, PPV of 100%. No complications occurred. Ascitic fluid cytology was concordant with the final diagnosis in 70% of cases. On CT, higher omental attenuation was significantly associated with diagnostic biopsies, whereas other CT features showed no significant correlation. US-guided omental biopsy is a safe, minimally invasive, and highly accurate technique for evaluating omental involvement.