Korean J Radiol.  2019 Jan;20(1):158-165. 10.3348/kjr.2018.0101.

The Role of Core Needle Biopsy for the Evaluation of Thyroid Nodules with Suspicious Ultrasound Features

Affiliations
  • 1Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. radbaek@naver.com
  • 2Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
  • 3Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
  • 4Department of Endocrinology and Metabolism, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Abstract


OBJECTIVE
Recent studies demonstrated that core needle biopsy (CNB) can effectively reduce the possibility of inconclusive results and prevent unnecessary diagnostic surgery. However, the effectiveness of CNB in patients with suspicious thyroid nodules has not been fully evaluated. This prospective study aimed to determine the potential of CNB to assess thyroid nodules with suspicious ultrasound (US) features.
MATERIALS AND METHODS
Patients undergoing CNB for thyroid nodules with suspicious features on US were enrolled between May and August 2016. Diagnostic performance and the incidence of non-diagnostic results, inconclusive results, conclusive results, malignancy, unnecessary surgery, and complications were analyzed. Subgroup analysis according to nodule size was performed. The risk factors associated with inconclusive results were evaluated using multivariate logistic regression analysis.
RESULTS
A total of 93 patients (102 thyroid nodules) were evaluated. All samples obtained from CNB were adequate for diagnosis. Inconclusive results were seen in 12.7% of cases. The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value for diagnosis of malignancy were 93.8%, 100%, 100%, 78.9%, and 95%, respectively. None of the patients underwent unnecessary surgery. The diagnostic performance was not significantly different according to nodule size. On multivariate logistic regression analysis, larger nodule size and shorter needle length were independent risk factors associated with inconclusive results.
CONCLUSION
Samples obtained by CNB were sufficient for diagnosis in all cases and resulted in high diagnostic values and conclusive results in the evaluation of suspicious thyroid nodules. These findings indicated that CNB is a promising diagnostic tool for suspicious thyroid nodules.

Keyword

Thyroid nodule; Core needle biopsy; Fine needle aspiration; Ultrasonography; Suspicious nodule

MeSH Terms

Biopsy, Fine-Needle
Biopsy, Large-Core Needle*
Diagnosis
Humans
Incidence
Logistic Models
Needles
Prospective Studies
Risk Factors
Sensitivity and Specificity
Thyroid Gland*
Thyroid Nodule*
Ultrasonography*
Unnecessary Procedures
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