Korean J Radiol.  2019 Oct;20(10):1454-1461. 10.3348/kjr.2018.0841.

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

• Hahn SY
• Shin JH
• Oh YL
• Park KW

• KMID: 2459164
• DOI: http://doi.org/10.3348/kjr.2018.0841

Abstract

OBJECTIVE
To retrospectively compare the diagnostic performances of two different ultrasound (US)-guided core needle biopsy (CNB) techniques for intermediate or low suspicion thyroid nodules.
MATERIALS AND METHODS
Between August 2015 and December 2016, two different biopsy techniques were alternatively applied for 248 consecutive thyroid nodules, of which, 140 intermediate or low suspicion thyroid nodules were included in this study. In the first technique, two specimens included nodular tissue, nodular margin, and surrounding normal parenchyma (i.e., marginal target). In the second technique, two specimens were obtained from two different target areas, one for the marginal target and another for the intranodular target. The diagnostic performances of the two techniques to predict neoplasm and malignancy were compared.
RESULTS
CNB was performed on 80 intermediate or low suspicion nodules (57.1%) using the first technique and on 60 (42.9%) using the second technique. The accuracy of the first technique for predicting neoplasm or malignancy was significantly higher than that of the second technique (100% vs. 93.3%, p = 0.032 for predicting neoplasm; 88.8% vs. 75.0%, p = 0.033 for predicting malignancy). The negative predictive value of the first technique for predicting malignancy was also significantly higher than that of the second technique (87.5% vs. 72.7%, p = 0.035).
CONCLUSION
For intermediate or low suspicion thyroid nodules, US-guided CNB to obtain two specimens with marginal targets is more effective for diagnosing neoplasm or malignancy than is CNB for respective marginal and intranodular targets.

Keyword

Thyroid; Ultrasound; Core needle biopsy; Technique; Thyroid cancer; Thyroid neoplasm

MeSH Terms

Biopsy
Biopsy, Large-Core Needle*
Diagnosis*
Methods*
Retrospective Studies
Thyroid Gland*
Thyroid Neoplasms
Thyroid Nodule*
Ultrasonography

Figure

• 

  Fig. 1 Study flow and outcomes of study population.Numbers represent number of thyroid nodules. CNB = core needle biopsy, FN or SFN = follicular neoplasm or suspicious for follicular neoplasm, K-TIRADS = Korean Thyroid Imaging Reporting and Data System, US = ultrasound

• 

  Fig. 2 Two CNB techniques.In first biopsy technique (A, B), two specimens included nodular tissue, nodular margin, and surrounding normal parenchyma (i.e., margin target). In second technique (C, D), two specimens were obtained from two different target areas, one from marginal target (C) and another from intranodular target (D). Arrows indicate specimen notch of biopsy needle.

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