Yonsei Med J.  2020 Feb;61(2):161-168. 10.3349/ymj.2020.61.2.161.

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

• Shin I
• Kim EK
• Moon HJ
• Yoon JH
• Park VY
• Lee SE
• Lee HS
• Kwak JY

• KMID: 2468491
• DOI: http://doi.org/10.3349/ymj.2020.61.2.161

Abstract

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.

Keyword

Ultrasonography; biopsy, fine-needle; thyroid neoplasms; biopsy, large-core needle

MeSH Terms

Biopsy*
Biopsy, Fine-Needle*
Biopsy, Large-Core Needle
Humans
Methods
Retrospective Studies
Sensitivity and Specificity
Thyroid Gland*
Thyroid Neoplasms
Thyroid Nodule*
Ultrasonography

Figure

• 

  Fig. 1 US images of a 35-year-old female with a papillary thyroid carcinoma, conventional type, which was diagnosed as “malignancy” on fine-needle aspiration and “nondiagnostic” on core-needle biopsy detected at an outside clinic. A 1.3-cm solid hypoechoic nodule (arrows) with microlobulated margins and mixed calcifications was seen on the axial (A) and longitudinal (B) scans of US. US, ultrasonography.

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