Factors Predicting Non-diagnostic Results in Ultrasound-Guided Percutaneous Pancreatic Biopsy

The present study aimed to evaluate the diagnostic adequacy and safety profile of ultrasound-guided percutaneous pancreatic biopsy and to determine predictors of non-diagnostic results. In this retrospective single-center study, consecutive patients who underwent ultrasound-guided percutaneous pancreatic biopsy between November 2022 and March 2026 were included. Lesion characteristics, biopsy technique, diagnostic adequacy, and complications were evaluated. Diagnostic adequacy was defined as obtaining sufficient tissue for pathological evaluation. Diagnostic and non-diagnostic biopsies were grouped, and lesion-related and procedural parameters were compared between the groups. Multivariable logistic regression analysis was performed to identify independent predictors of non-diagnostic biopsy. A total of 125 patients (mean age, 66.8 ± 10.4 years; 55.2% male) were included in the study. The overall diagnostic adequacy was 78.4% (98/125). Among diagnostic biopsies, 79 were reported as malignant, 16 as suspicious for malignancy, and 3 as benign. Fine-needle aspiration biopsy was performed in 97 patients (77.6%), whereas core needle biopsy was performed in 28 patients (22.4%). In multivariable analysis, smaller lesion size (OR: 0.96, 95% CI: 0.93–0.99; p=0.014) and the presence of a cystic component (OR: 3.42, 95% CI: 1.21–9.66; p=0.020) were identified as independent risk factors for non-diagnostic biopsy. No major complications were observed, while minor complications, including abdominal pain or hemorrhage not requiring additional treatment, occurred in 5.6% of patients. In conclusion, ultrasound-guided percutaneous pancreatic biopsy is a safe and effective method with acceptable diagnostic adequacy. Lesion size and the presence of a cystic component are important factors affecting diagnostic adequacy and should be considered during procedural planning.