Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 2/2017

01-02-2017 | Head and Neck

Fine-needle aspiration versus core needle biopsy for diagnosis of thyroid malignancy and neoplasm: a matched cohort study

Authors: Soo-Yeon Kim, Hye Sun Lee, Jieun Moon, Eun-Kyung Kim, Hee Jung Moon, Jung Hyun Yoon, Jin Young Kwak

Published in: European Radiology | Issue 2/2017

Login to get access

Abstract

Objectives

To compare the diagnostic performances of fine-needle aspiration (FNA) and core needle biopsy (CNB) in the diagnosis of thyroid malignancy and neoplasm in patients who underwent surgery for thyroid nodules.

Methods

This retrospective study was approved by the institutional review board, and the need to obtain informed consent was waived. 3192 patients who underwent FNA (n = 3048) or CNB (n = 144) for diagnosis of thyroid nodules and then proceeded with surgery were included. Surgical pathologic diagnosis was the reference standard. Diagnostic performances of FNA and CNB to predict malignancy and neoplasm were compared. Propensity score matching was used to match patients with FNA with those with CNB because there were significant differences in the number of nodules and nodule characteristics between the FNA and CNB groups.

Results

Before matching, the sensitivity and accuracy of FNA were significantly higher or comparable with those of CNB, and the specificity, negative predictive value and positive predictive value were comparable. After matching, the diagnostic performances were similar, with the exception of specificity for predicting neoplasm being higher with CNB than with FNA.

Conclusion

FNA showed comparable diagnostic performance to CNB; therefore, there may be no benefit in performing CNB to diagnose papillary thyroid carcinoma and neoplasm.

Key Points

• Diagnostic performances of FNA and CNB for thyroid malignancy and neoplasm were compared.
• FNA showed comparable performances to CNB both before and after statistical matching.
• There may be no benefit in performing CNB, given the comparable performances.
Literature
1.
Cooper DS, Doherty GM, Haugen BR et al (2009) Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association (ATA) guidelines taskforce on thyroid nodules and differentiated thyroid cancer. Thyroid 19:1167–1214CrossRefPubMed
2.
Gharib H, Papini E, Paschke R et al (2010) AACE/AME/ETA Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: executive summary of recommendations. Endocr Pract 16:1–43CrossRefPubMed
3.
Yoon JH, Moon HJ, Kim E-K, Kwak JY (2011) Inadequate cytology in thyroid nodules: should we repeat aspiration or follow-up? Ann Surg Oncol 18:1282–1289CrossRefPubMed
4.
Yoon JH, Kwak JY, Kim E-K et al (2010) How to approach thyroid nodules with indeterminate cytology. Ann Surg Oncol 17:2147–2155CrossRefPubMed
5.
6.
Na DG, Kim J-H, Sung JY et al (2012) Core-needle biopsy is more useful than repeat fine-needle aspiration in thyroid nodules read as nondiagnostic or atypia of undetermined significance by the Bethesda system for reporting thyroid cytopathology. Thyroid 22:468–475CrossRefPubMed
7.
Ha EJ, Baek JH, Lee JH et al (2013) Sonographically suspicious thyroid nodules with initially benign cytologic results: the role of a core needle biopsy. Thyroid 23:703–708CrossRefPubMed
8.
Choi SH, Baek JH, Lee JH et al (2014) Thyroid nodules with initially non-diagnostic, fine-needle aspiration results: comparison of core-needle biopsy and repeated fine-needle aspiration. Eur Radiol 24:2819–2826CrossRefPubMed
9.
Sung JY, Na DG, Kim KS et al (2012) Diagnostic accuracy of fine-needle aspiration versus core-needle biopsy for the diagnosis of thyroid malignancy in a clinical cohort. Eur Radiol 22:1564–1572CrossRefPubMed
10.
Yeon JS, Baek JH, Lim HK et al (2013) Thyroid nodules with initially nondiagnostic cytologic results: the role of core-needle biopsy. Radiology 268:274–280CrossRefPubMed
11.
Park KT, Ahn SH, Mo JH et al (2011) Role of core needle biopsy and ultrasonographic finding in management of indeterminate thyroid nodules. Head Neck 33:160–165CrossRefPubMed
12.
Choi YJ, Baek JH, Ha EJ et al (2014) Differences in risk of malignancy and management recommendations in subcategories of thyroid nodules with atypia of undetermined significance or follicular lesion of undetermined significance: the role of ultrasound-guided core-needle biopsy. Thyroid 24:494–501CrossRefPubMed
13.
Zhang M, Zhang Y, Fu S, Lv F, Tang J (2014) Thyroid nodules with suspicious ultrasound findings: the role of ultrasound-guided core needle biopsy. Clin Imaging 38:434–438CrossRefPubMed
14.
Khoo T-K, Baker C, Hallanger-Johnson J et al (2008) Comparison of ultrasound-guided fine-needle aspiration biopsy with core-needle biopsy in the evaluation of thyroid nodules. Endocr Pract 14:426–431CrossRefPubMed
15.
Ha EJ, Baek JH, Lee JH et al (2014) Core needle biopsy can minimise the non-diagnostic results and need for diagnostic surgery in patients with calcified thyroid nodules. Eur Radiol 24:1403–1409CrossRefPubMed
16.
Yoon JH, Kim E-K, Kwak JY, Moon HJ (2015) Effectiveness and limitations of core needle biopsy in the diagnosis of thyroid nodules: review of current literature. J Pathol Transl Med 49:230CrossRefPubMedPubMedCentral
17.
Kim YH, Kwon HJ, Kim E-K, Kwak JY, Moon HJ, Yoon JH (2015) Applying ultrasound-guided core needle biopsy for diagnosis of thyroid masses: preliminary results from a single institution. J Ultrasound Med 34:1801–1808CrossRefPubMed
18.
Karstrup S, Balslev E, Juul N, Eskildsen PC, Baumbach L (2001) US-guided fine needle aspiration versus coarse needle biopsy of thyroid nodules. Eur J Ultrasound 13:1–5CrossRefPubMed
19.
Renshaw AA, Pinnar N (2007) Comparison of thyroid fine-needle aspiration and core needle biopsy. Am J Clin Pathol 128:370–374CrossRefPubMed
20.
Li L, Chen B-D, Zhu H-F et al (2013) Comparison of pre-operation diagnosis of thyroid cancer with fine needle aspiration and core-needle biopsy: a meta-analysis. Asian Pac J Cancer Prev 15:7187–7193CrossRef
21.
Hakala T, Kholová I, Sand J, Saaristo R, Kellokumpu-Lehtinen P (2013) A core needle biopsy provides more malignancy-specific results than fine-needle aspiration biopsy in thyroid nodules suspicious for malignancy. J Clin Pathol 66:1046–1050CrossRefPubMed
22.
Kim EK, Park CS, Chung WY et al (2002) New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid. AJR Am J Roentgenol 178:687–691CrossRefPubMed
23.
Cibas ES, Ali SZ (2009) The Bethesda system for reporting thyroid cytopathology. Am J Clin Pathol 132:658–665CrossRefPubMed
24.
Austin PC, Grootendorst P, Anderson GM (2007) A comparison of the ability of different propensity score models to balance measured variables between treated and untreated subjects: a Monte Carlo study. Stat Med 26:734–753CrossRefPubMed
25.
Clary KM, Condel JL, Liu Y, Johnson DR, Grzybicki DM, Raab SS (2005) Interobserver variability in the fine needle aspiration biopsy diagnosis of follicular lesions of the thyroid gland. Acta Cytol 49:378–382CrossRefPubMed
26.
Lee SH, Kim MH, Bae JS, Lim DJ, Jung SL, Jung CK (2014) Clinical outcomes in patients with non-diagnostic thyroid fine needle aspiration cytology: usefulness of the thyroid core needle biopsy. Ann Surg Oncol 21:1870–1877CrossRefPubMed
27.
Samir AE, Vij A, Seale MK et al (2012) Ultrasound-guided percutaneous thyroid nodule core biopsy: clinical utility in patients with prior nondiagnostic fine-needle aspirate. Thyroid 22:461–467CrossRefPubMedPubMedCentral
28.
Haugen B, Alexander E, Bible K et al (2016) 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 26:1–133CrossRefPubMedPubMedCentral
29.
Anderson TJ, Atalay MK, Grand DJ, Baird GL, Cronan JJ, Beland MD (2014) Management of nodules with initially nondiagnostic results of thyroid fine-needle aspiration: can we avoid repeat biopsy? Radiology 272:777–784CrossRefPubMed
30.
Yoon JH, Lee HS, Kim E-K, Moon HJ, Kwak JY (2015) Thyroid nodules: nondiagnostic cytologic results according to thyroid imaging reporting and data system before and after application of the Bethesda system. Radiology 276:579–587CrossRefPubMed
31.
Yoon RG, Baek JH, Lee JH et al (2014) Diagnosis of thyroid follicular neoplasm: fine-needle aspiration versus core-needle biopsy. Thyroid 24:1612–1617CrossRefPubMed
32.
Novoa E, Gürtler N, Arnoux A, Kraft M (2012) Role of ultrasound‐guided core‐needle biopsy in the assessment of head and neck lesions: a meta‐analysis and systematic review of the literature. Head Neck 34:1497–1503CrossRefPubMed
33.
Min HS, Kim JH, Ryoo I, Jung SL, Jung CK (2014) The role of core needle biopsy in the preoperative diagnosis of follicular neoplasm of the thyroid. APMIS 122:993–1000CrossRefPubMed
34.
35.
Nasrollah N, Trimboli P, Rossi F et al (2014) Patient’s comfort with and tolerability of thyroid core needle biopsy. Endocrine 45:79–83CrossRefPubMed
36.
Jung CK, Min HS, Park HJ et al (2015) Pathology reporting of thyroid core needle biopsy: a proposal of the Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Group. J Pathol Transl Med 49:288CrossRefPubMedPubMedCentral
37.
Hahn S, Shin J, Han B, Ko E, Ko E (2013) Ultrasonography-guided core needle biopsy for the thyroid nodule: does the procedure hold any benefit for the diagnosis when fine-needle aspiration cytology analysis shows inconclusive results? Br J Radiol 86:20130007CrossRefPubMedPubMedCentral
Metadata
Title
Fine-needle aspiration versus core needle biopsy for diagnosis of thyroid malignancy and neoplasm: a matched cohort study
Authors
Soo-Yeon Kim
Hye Sun Lee
Jieun Moon
Eun-Kyung Kim
Hee Jung Moon
Jung Hyun Yoon
Jin Young Kwak
Publication date
01-02-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4424-1

Other articles of this Issue 2/2017

European Radiology 2/2017 Go to the issue

Neuro

The value of qualitative and quantitative assessment of lesion to cerebral cortex signal ratio on double inversion recovery sequence in the differentiation of demyelinating plaques from non-specific T2 hyperintensities

Musculoskeletal

C-arm flat-panel CT arthrography of the shoulder: Radiation dose considerations and preliminary data on diagnostic performance

Neuro

Usefulness of colour Doppler flow imaging in the management of lacrimal gland lesions

Computed Tomography

Single- and dual-energy CT of the abdomen: comparison of radiation dose and image quality of 2nd and 3rd generation dual-source CT

Breast

Comparison of visibility of circumscribed masses on Digital Breast Tomosynthesis (DBT) and 2D mammography: are circumscribed masses better visualized and assured of being benign on DBT?

Oncology

CT measurement of breast glandular tissue and its association with testicular cancer