Ultrasound-Guided Core Needle Biopsy Techniques for Intermediate or Low Suspicion Thyroid Nodules: Which Method is Effective for Diagnosis?

Hahn, Soo Yeon; Shin, Jung Hee; Oh, Young Lyun; Park, Ko Woon

doi:10.3348/kjr.2018.0841

Cited by 7 publications

(3 citation statements)

References 32 publications

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“…We proposed a flow chart for diagnosing FN close to FTC as to how patients should proceed safely and quickly (Figure ). A technique of US‐guided CNB for intermediate or low suspicion thyroid nodules has reported that obtaining two specimens with marginal targets is more effective for diagnosing neoplasm or malignancy . As an initial attempt, CNB is appropriate for nodules 2cm or larger.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound‐guided fine‐needle aspiration or core needle biopsy for diagnosing follicular thyroid carcinoma?

Park

Shin

Hahn

et al. 2020

Clinical Endocrinology

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Objective:We evaluated the preoperative diagnostic values of ultrasound (US), fineneedle aspiration (FNA) and core needle biopsy (CNB) leading to surgery in patients with FTC. Methods:From October 1994 to July 2016, 298 patients with FTC who had preoperative US images and underwent US-guided FNA or CNB and surgery were included in this study. We evaluated the results of preoperative FNA or CNB based on the Bethesda system and the US findings according to the Korean thyroid imaging reporting and data system (K-TIRADS). Results:Predominant US features of FTC showed solid, hypo-or iso-echogenicity, oval smooth margin and halo with no calcification. Based on K-TIRADS, 140 (47.0%) patients with FTC were categorized as low suspicion, 133 (44.63%) as intermediate suspicion and 25 (8.4%) as high suspicion at US. Considering only FNA cytology (n = 230), 6.9% were revealed as Bethesda class I, 16.1% as class II, 37.0% as class III, 29.1% as class IV and 10.9% as class V. Considering the 68 cases with CNB results, 2.9% were revealed as class I, 4.4% as class II, 20.6% as class III and 72.1% as class IV. Despite multiple FNAs, 16.7% of the 84 patients with FTC still obtained Bethesda class I or class II. CNB results in patients with FTC had a significantly higher rate of Bethesda class IV compared to the FNA results (P < .001). FTCs with distant metastasis exhibited a significantly higher rate of Bethesda classes IV and V compared to those without distant metastasis (P = .004). Conclusion:Surgery for FTC is deferred only with preoperative US and FNA. CNB in patients with FTC can lead to surgery better than FNA. Therefore, if the US feature is characteristic and a serially growing large nodule is suspected, the first attempt of CNB may be helpful in selecting a surgical candidate. K E Y W O R D S core needle biopsy, fine-needle aspiration, follicular thyroid carcinoma, thyroid neoplasm, ultrasonography | 469 PARK et Al.

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Section: Discussionmentioning

confidence: 99%

Ultrasound‐guided fine‐needle aspiration or core needle biopsy for diagnosing follicular thyroid carcinoma?

Park

Shin

Hahn

et al. 2020

Clinical Endocrinology

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“…Core-needle biopsy (CNB) has emerged as a diagnostic tool for thyroid nodules based on recent advances in core biopsy devices (spring-activated single-or double-action needles) and the widespread use of highresolution ultrasonography (US) [8,9]. CNB has been reported to be an effective and safe diagnostic tool, as it allows clinicians to obtain a core tissue sample with potential information on architectural histological structures, thus enabling immunochemical staining [10][11][12][13]. Based on these advantages, many global guidelines have begun to recommend CNB as a diagnostic tool for thyroid nodules [14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Distribution and malignancy risk of six categories of the pathology reporting system for thyroid core-needle biopsy in 1,216 consecutive thyroid nodules

Son

Kim

et al. 2020

Ultrasonography

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Ultrasonography 2020;39:159-165 Purpose: The purpose of this study was to present the distribution of lesions among the six categories of the pathology reporting system for thyroid core-needle biopsy (CNB), along with the range of malignancy risk of each category based on different diagnostic criteria for benignity in a clinical cohort. Methods: For 1,216 consecutive nodules (≥1 cm) of 1,125 patients who underwent CNB at two hospitals, the diagnostic results based on the six categories of thyroid CNB were analyzed. Patients were divided into three groups according to prior fine-needle aspiration (FNA) status: second-line CNB for nodules where prior FNA yielded nondiagnostic or unsatisfactory results (n=57), second-line CNB for nodules with prior FNA results of atypia/follicular lesion of undetermined significance (AUS/FLUS) (n=303), and first-line CNB (n=856). Results: The proportion of nodules in each CNB category and the range of the malignancy rate for each category was as follows, in order from category I to VI: 1.8%, 23.1%-75.0%; 57.9%, 0.7%-16.7%; 16.0%, 13.2%-46.7%; 8.8%, 53.8%-56.8%; 2.0%, 100%; and 13.5%, 100%. First-line CNB was associated with a higher rate of conclusive diagnoses (category II, IV, or VI) (725 of 856, 84.7%) than second-line CNB with prior nondiagnostic or AUS/FLUS FNA results (241 of 360, 66.9%; P<0.001). Conclusion: The overall distribution of nodules across the six categories of thyroid CNB and the ranges of malignancy risk for those categories were presented in a clinical cohort. Firstline CNB tended to produce a higher rate of conclusive results than second-line CNB with prior inconclusive FNA results.

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“…Therefore, to simplify the nodule diagnosis, current thyroid guidelines (Thyroid Imaging Reporting And Data System (TIRADS)) advocate the use of ultrasonography (USG) as a preliminary test for all patients suspected of having thyroid nodule. 2,3 Clinical variables and ultrasound (US) findings as per the TIRADS guidelines are recommended as a primary criterion to assess the benign and malignant nature of a nodule. Based on these results, the clinician further advises an additional confirmatory testing (FNAB) or simple routine US follow-up.…”

Section: Introductionmentioning

confidence: 99%

Thyroid nodule ultrasound accuracy in predicting thyroid malignancy based on TIRADS system

Nie¹,

Zhu²,

Yan³

et al. 2022

Adv Clin Exp Med

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Background. A frequent prevalence of thyroid nodules in patients prioritizes the need for an accurate method that characterizes them as benign or malignant. Fine-needle aspiration biopsy (FNAB) and thyroid ultrasonography (USG) are currently used for this purpose. However, since FNAB is complicated, time-consuming and expensive, thyroid USG, a fast and highly sensitive method, is preferably used. Although USG is reported as a suitable method for characterization of thyroid nodules, there are some contrasting studies available which report its limited use in the differentiation of benign and malignant thyroid nodules.Objectives. This meta-analysis aims to assess the accuracy of ultrasound in predicting thyroid cancer in terms of sensitivity, specificity and diagnostic odds ratios (ORs) for positive and negative results. Materials and methods.Systematic and extensive literature search on the use of ultrasound (US) to predict thyroid cancer was conducted in the databases of Scopus, CINAHL (via EBSCO), MEDLINE (via PubMed), and Web of Science, covering the period from 2010 till 2021. The morphological features of thyroid nodules observed during the USG were analyzed based on Thyroid Imaging Reporting And Data System (TIRADS) guidelines. The accuracy of thyroid US was determined using parameters such as sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic ORs. Moreover, the respective forest plot and hierarchical summary receiver operating characteristics (HSROC) curve were plotted.Results. A total of 2765 reference studies were examined, and among them, 15 relevant references were selected. The selected studies were heterogeneous and included retrospective and prospective studies. The risk of publication bias is low as the p-value for both Egger's and Begg's tests is >0.05. The overall sensitivity of 92.53% (95% confidence interval (95% CI): [84.55%; 96.33%]), specificity of 33.88% (95% CI: [23. 16%; 45.53%]) and diagnostic OR of 12.36 (95% CI: [3.90%; 54. 11%]) are achieved. These results were statistically significant with a p-value < 0.001 and are predictive of US accuracy in detecting cancer.Conclusions. The present meta-analysis, on the basis of statistically significant results, demonstrated the high accuracy of thyroid ultrasound in detection of malignant nature of nodules in patients suspected with a worrisome thyroid nodule.

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Ultrasound-Guided Core Needle Biopsy Techniques for Intermediate or Low Suspicion Thyroid Nodules: Which Method is Effective for Diagnosis?

Cited by 7 publications

References 32 publications

Ultrasound‐guided fine‐needle aspiration or core needle biopsy for diagnosing follicular thyroid carcinoma?

Ultrasound‐guided fine‐needle aspiration or core needle biopsy for diagnosing follicular thyroid carcinoma?

Distribution and malignancy risk of six categories of the pathology reporting system for thyroid core-needle biopsy in 1,216 consecutive thyroid nodules

Thyroid nodule ultrasound accuracy in predicting thyroid malignancy based on TIRADS system

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