Comparison Between Fine Needle Aspiration and Core Needle Biopsy for the Diagnosis of Thyroid Nodules: Effective Indications According to US Findings

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

Abstract

Thyroid nodules are initially handled by fine needle aspiration (FNA). However, the stance of thyroid core needle biopsy (CNB) still is a challenge. This study aimed to compare the diagnostic performances and conclusive rates of FNA and CNB for the diagnosis of thyroid nodules and to define effective indications of CNB. This retrospective study enrolled 1,060 consecutive thyroid nodules in 1,037 patients who underwent FNA from January 2008 to May 2008, and 462 consecutive nodules in 453 patients who underwent CNB from January 2014 to December 2015 at our institution. Ultrasound (US) features were classified according to the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) and Korean TIRADS (K-TIRADS). We compared diagnostic performances and conclusive rates between FNA and CNB groups. Propensity score matching was conducted to match FNA patients with CNB patients. After matching, the diagnostic performances for selecting surgical candidates and predicting malignancy were comparable between the two biopsy groups. Based on US findings, conclusive results were obtained significantly more in CNB than in FNA when thyroid nodules were classified as ACR TI-RADS or K-TIRADS category 4 and measured larger than 2 cm. Diagnostic performances between FNA and CNB were comparable. Superiority of CNB to FNA was found for thyroid nodules larger than 2 cm and classified as ACR TI-RADS or K-TIRADS category 4.

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flowchart of patient population according to inclusion and exclusion criteria. From January 2008 to May 2008, 1,096 consecutive patients underwent FNA for 1,109 thyroid nodules (≥1 cm) at our institution. The study included 1,060 nodules in 1,036 patients for the conclusive rates, and 621 nodules in 615 patients for diagnostic performance. A total of 452 consecutive patients with 462 thyroid nodules (≥1 cm) underwent CNB at our institution between January 2014 and December 2015. The study included 462 nodules in 452 patients for the conclusive rates, and 330 nodules in 322 patients for the diagnostic performance.

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