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

Kim, Soo Yeon; Lee, Hye Sun; Moon, Jaekyun; Kim, Min Jung; Moon, Hee Jung; Yoon, Jung Hyun; Kwak, Jin Young

doi:10.1007/s00330-016-4424-1

Cited by 26 publications

(17 citation statements)

References 41 publications

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“…Two main advantages of CNB have been previously suggested: a high diagnostic accuracy for thyroid malignancy; and a low false-positive rate for follicular neoplasm. Regarding the diagnostic accuracy for thyroid malignancy, several studies compared the results of CNB and FNA (4,11,(20)(21)(22)(23). In these studies, both CNB (98-100%) and FNA (95-100%) showed high specificities; however, the sensitivities were slightly higher for CNB than for FNA (81-96% vs. 61-84%).…”

Section: Discussionmentioning

confidence: 99%

Core needle biopsy of thyroid nodules: outcomes and safety from a large single-center single-operator study

et al. 2017

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Background There currently remains a debate over the use of core needle biopsy (CNB) or fine needle aspiration (FNA) for diagnosis of thyroid nodules. The major drawbacks of previous CNB studies include heterogeneity of the study population, variable techniques, devices, and operator experience affecting the outcome of the procedure. Purpose To assess the diagnostic performance and safety of CNB of thyroid nodules performed by a single experienced operator in consecutive patients. Material and Methods From January 2012 to December 2012, 538 thyroid nodules that underwent CNB were retrospectively evaluated. All CNB procedures were performed by a single operator with 18 years of experience. The histopathology of the surgical specimens was considered as the standard reference for malignancy. A final diagnosis of benignity was made by surgery, one benign lesion on FNA and/or CNB with no change on follow-up examinations (>1 year) or benign lesion on ≥2 FNA and/or CNB. The diagnostic performance, incidence of technical failure, unnecessary surgery, and complication were evaluated. Results The diagnostic accuracy, sensitivity, and specificity of CNB for malignancy were 92.0%, 85.3%, and 100%, respectively. The non-diagnostic result rate of CNB was 4.8% (26/538) and the inconclusive result rate was 24.3% (131/538). The incidence of technical failure was 0.6% (3/541) and unnecessary surgery was 0.6%. The complication rate was 0.2%, without life-threatening complications. The sensitivity, specificity, and accuracy were 85.3% (156/183), 100.0% (154/154), and 92.0% (310/337), respectively. Conclusion CNB shows a high diagnostic performance for detection of thyroid malignancy and follicular neoplasm, with low rates of technical failure and complications.

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Section: Discussionmentioning

confidence: 99%

Core needle biopsy of thyroid nodules: outcomes and safety from a large single-center single-operator study

et al. 2017

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“…Seven of these hospitals also published data about CNB and reported its advantages over FNA; these hospitals were categorized as favoring CNB. One hospital focused on the weaknesses or disadvantages of CNB in four papers [22,43,58,59]; despite publishing papers on CNB, we categorized this hospital as not favoring CNB. Head and neck surgeons working at five other hospitals without a paper on CNB were contacted to obtain information on their use of CNB, and they confirmed that they rarely used CNB in clinical settings.…”

Section: Differences In the Proportions Of Diagnoses On Consecutive Fmentioning

confidence: 99%

Usage and Diagnostic Yield of Fine-Needle Aspiration Cytology and Core Needle Biopsy in Thyroid Nodules: A Systematic Review and Meta-Analysis of Literature Published by Korean Authors

Ahn

2021

Clin Exp Otorhinolaryngol

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Objectives. The usefulness of core needle biopsy (CNB) for the diagnosis of thyroid nodules remains controversial, and preferences vary across hospitals. The purpose of this study was to assess the actual use of CNB in Korea and to analyze the advantages and disadvantages of CNB through a systematic review and meta-analysis of papers published by Korean authors. Methods. A meta-analysis of full-text publications published in English presenting data from Korea retrieved from the Embase literature database was performed. Results. CNB led to a significantly lower proportion of non-diagnostic results than fine-needle aspiration (FNA). However, the frequency of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) did not decrease as a result of performing CNB in nodules with initial AUS/FLUS results, while it increased in consecutive cases. A subcategory analysis of AUS/FLUS showed that the increased frequency of AUS/FLUS findings on CNB was due to more frequent diagnoses of architectural atypia and follicular neoplasm, which resulted in a higher frequency of inconclusive findings in consecutive cases compared to FNA. Hospitals favoring CNB had a higher proportion of AUS/FLUS diagnoses. Although the complication rate did not differ significantly between CNB and FNA, serious complications of CNB did occur. Conclusion. A reduced frequency of non-diagnostic results may be a definite advantage of CNB over FNA. However, the increased frequency of diagnoses of architectural atypia and follicular neoplasm should be considered when selecting CNB as a diagnostic tool.

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“…Ultrasonography (US) guided-fine-needle aspiration (FNA) has been used as the primary diagnostic tool for thyroid nodules, owing to its safety, simplicity, cost-effectiveness, and reliability. 1 Since early 2010, several articles have demonstrated the safety and tolerability of core-needle biopsy (CNB) for the evaluation of thyroid nodules, as well as its diagnostic efficacy. [2][3][4][5][6][7][8] Unlike FNA, which has been validated as a standard diagnostic method for over half a century, the value of CNB has not yet been fully evaluated for diagnosing thyroid nodules.…”

Section: Introductionmentioning

confidence: 99%

“…12 To overcome this weakness, some investigators have suggested CNB as alternative or complementary diagnostic tool for thyroid nodules, 5,8,[13][14][15][16] even though CNB does not show superior diagnostic performance to FNA for diagnosing thyroid cancer and poses a higher rate of post-biopsy hematoma than FNA. 1,17 Many favorable results for CNB have been found in studies conducted by experienced radiologists and CNB has even been used to diagnose small nodules, 5,8,15,16,18 even micronodules not indicated for FNA in prestigious guide-…”

Section: Introductionmentioning

confidence: 99%

Core-Needle Biopsy Does Not Show Superior Diagnostic Performance to Fine-Needle Aspiration for Diagnosing Thyroid Nodules

et al. 2020

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Purpose: To compare the diagnostic performances of fine-needle aspiration (FNA) and core-needle biopsy (CNB) for thyroid nodules according to nodule size. Materials and Methods: This retrospective study included 320 thyroid nodules from 320 patients who underwent both FNA and CNB at outside clinics and proceeded with surgery in our institution between July 2012 and May 2019. According to nodule size, the diagnostic performances of FNA and CNB were calculated using various combinations of test-negatives and test-positives defined by the Bethesda categories and were compared using the generalized estimated equation and the Delong method. Results: There were 279 malignant nodules in 279 patients and 41 benign nodules in 41 patients. The diagnostic performance of FNA was mostly not different from CNB regardless of nodule size, except for negative predictive value, which was better for FNA than CNB when applying Criteria 1 and 2. When applying Criteria 3, the specificity and positive predictive value of FNA were superior to CNB regardless of size. When applying Criteria 4, diagnostic performance did not differ between FNA and CNB regardless of size. After applying Criteria 5, diagnostic performance did not differ between FNA and CNB in nodules ≥2 cm. However, in nodules ≥1 cm and all nodules, the sensitivity, accuracy, and negative predictive value of CNB were better than those of FNA. Conclusion: CNB did not show superior diagnostic performance to FNA for diagnosing thyroid nodules.

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

Abstract: • 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.

Cited by 26 publications

References 41 publications

Core needle biopsy of thyroid nodules: outcomes and safety from a large single-center single-operator study

Core needle biopsy of thyroid nodules: outcomes and safety from a large single-center single-operator study

Usage and Diagnostic Yield of Fine-Needle Aspiration Cytology and Core Needle Biopsy in Thyroid Nodules: A Systematic Review and Meta-Analysis of Literature Published by Korean Authors

Core-Needle Biopsy Does Not Show Superior Diagnostic Performance to Fine-Needle Aspiration for Diagnosing Thyroid Nodules

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