Usefulness of core needle biopsy for thyroid nodules with macrocalcifications: Comparison with fine-needle aspiration

Kyung Sik Yi, Ji Hoon Kim, Dong Gyu Na, Hyobin Seo, Hye Sook Min, Jae Kyung Won, Tae Jin Yun, Inseon Ryoo, Su Chin Kim, Seung Hong Choi, Chul Ho Sohn

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Abstract

Background: This study was performed to determine the benefits of core needle biopsy (CNB), as compared with fine-needle aspiration (FNA), for the diagnosis of thyroid nodules with macrocalcifications. Materials and Methods: The institutional review board approved this retrospective study, and informed consent was waived. From February 2010 to March 2012, the study included 147 thyroid nodules with macrocalcification of 145 consecutive patients who underwent simultaneous FNA and CNB for each nodule. Diagnostic accuracy and inconclusive diagnoses, including nondiagnostic reading and atypia of undetermined significance or follicular lesion of undetermined significance reading were compared among FNA, CNB, and a combination of FNA and CNB (FNA/CNB) using McNemar's test; the benefits of CNB were calculated. Results: Compared to FNA, CNB and FNA/CNB showed fewer inconclusive diagnoses (FNA vs. CNB: 62/147 [42.2%] vs. 14/147 [9.5%], p<0.001; FNA vs. FNA/CNB: 62/147 [42.2%] vs. 14/147 [9.5%], p<0.001), resulting in the avoidance of repeat FNA or diagnostic surgery in 48 of 62 patients (77.4%, respectively in CNB and FNA/CNB) who would have undergone these procedures if only FNA was performed. Compared to FNA, FNA/CNB showed higher sensitivity and accuracy (sensitivity: 23/32 [71.9%] vs. 31/32 [96.9%], p=0.008; accuracy: 77/86 [89.5%] vs. 85/86 [98.8%], p=0.008), resulting in avoidance of delayed surgery in eight of nine patients (88.9%) with thyroid cancer in whom the surgery would have been missed if FNA only had been performed. Conclusion: In the workup of thyroid nodules with macrocalcification, compared with FNA alone, FNA/CNB decreases inconclusive diagnoses and increases sensitivity, thereby reducing repeated FNA procedures, diagnostic surgeries, and delayed therapeutic surgeries.

Original languageEnglish
Pages (from-to)657-664
Number of pages8
JournalThyroid
Volume25
Issue number6
DOIs
Publication statusPublished - 2015 Jun 1

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Large-Core Needle Biopsy
Thyroid Nodule
Fine Needle Biopsy
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ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Yi, K. S., Kim, J. H., Na, D. G., Seo, H., Min, H. S., Won, J. K., ... Sohn, C. H. (2015). Usefulness of core needle biopsy for thyroid nodules with macrocalcifications: Comparison with fine-needle aspiration. Thyroid, 25(6), 657-664. https://doi.org/10.1089/thy.2014.0596

Usefulness of core needle biopsy for thyroid nodules with macrocalcifications : Comparison with fine-needle aspiration. / Yi, Kyung Sik; Kim, Ji Hoon; Na, Dong Gyu; Seo, Hyobin; Min, Hye Sook; Won, Jae Kyung; Yun, Tae Jin; Ryoo, Inseon; Kim, Su Chin; Choi, Seung Hong; Sohn, Chul Ho.

In: Thyroid, Vol. 25, No. 6, 01.06.2015, p. 657-664.

Research output: Contribution to journalArticle

Yi, KS, Kim, JH, Na, DG, Seo, H, Min, HS, Won, JK, Yun, TJ, Ryoo, I, Kim, SC, Choi, SH & Sohn, CH 2015, 'Usefulness of core needle biopsy for thyroid nodules with macrocalcifications: Comparison with fine-needle aspiration', Thyroid, vol. 25, no. 6, pp. 657-664. https://doi.org/10.1089/thy.2014.0596
Yi, Kyung Sik ; Kim, Ji Hoon ; Na, Dong Gyu ; Seo, Hyobin ; Min, Hye Sook ; Won, Jae Kyung ; Yun, Tae Jin ; Ryoo, Inseon ; Kim, Su Chin ; Choi, Seung Hong ; Sohn, Chul Ho. / Usefulness of core needle biopsy for thyroid nodules with macrocalcifications : Comparison with fine-needle aspiration. In: Thyroid. 2015 ; Vol. 25, No. 6. pp. 657-664.
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abstract = "Background: This study was performed to determine the benefits of core needle biopsy (CNB), as compared with fine-needle aspiration (FNA), for the diagnosis of thyroid nodules with macrocalcifications. Materials and Methods: The institutional review board approved this retrospective study, and informed consent was waived. From February 2010 to March 2012, the study included 147 thyroid nodules with macrocalcification of 145 consecutive patients who underwent simultaneous FNA and CNB for each nodule. Diagnostic accuracy and inconclusive diagnoses, including nondiagnostic reading and atypia of undetermined significance or follicular lesion of undetermined significance reading were compared among FNA, CNB, and a combination of FNA and CNB (FNA/CNB) using McNemar's test; the benefits of CNB were calculated. Results: Compared to FNA, CNB and FNA/CNB showed fewer inconclusive diagnoses (FNA vs. CNB: 62/147 [42.2{\%}] vs. 14/147 [9.5{\%}], p<0.001; FNA vs. FNA/CNB: 62/147 [42.2{\%}] vs. 14/147 [9.5{\%}], p<0.001), resulting in the avoidance of repeat FNA or diagnostic surgery in 48 of 62 patients (77.4{\%}, respectively in CNB and FNA/CNB) who would have undergone these procedures if only FNA was performed. Compared to FNA, FNA/CNB showed higher sensitivity and accuracy (sensitivity: 23/32 [71.9{\%}] vs. 31/32 [96.9{\%}], p=0.008; accuracy: 77/86 [89.5{\%}] vs. 85/86 [98.8{\%}], p=0.008), resulting in avoidance of delayed surgery in eight of nine patients (88.9{\%}) with thyroid cancer in whom the surgery would have been missed if FNA only had been performed. Conclusion: In the workup of thyroid nodules with macrocalcification, compared with FNA alone, FNA/CNB decreases inconclusive diagnoses and increases sensitivity, thereby reducing repeated FNA procedures, diagnostic surgeries, and delayed therapeutic surgeries.",
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T2 - Comparison with fine-needle aspiration

AU - Yi, Kyung Sik

AU - Kim, Ji Hoon

AU - Na, Dong Gyu

AU - Seo, Hyobin

AU - Min, Hye Sook

AU - Won, Jae Kyung

AU - Yun, Tae Jin

AU - Ryoo, Inseon

AU - Kim, Su Chin

AU - Choi, Seung Hong

AU - Sohn, Chul Ho

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Background: This study was performed to determine the benefits of core needle biopsy (CNB), as compared with fine-needle aspiration (FNA), for the diagnosis of thyroid nodules with macrocalcifications. Materials and Methods: The institutional review board approved this retrospective study, and informed consent was waived. From February 2010 to March 2012, the study included 147 thyroid nodules with macrocalcification of 145 consecutive patients who underwent simultaneous FNA and CNB for each nodule. Diagnostic accuracy and inconclusive diagnoses, including nondiagnostic reading and atypia of undetermined significance or follicular lesion of undetermined significance reading were compared among FNA, CNB, and a combination of FNA and CNB (FNA/CNB) using McNemar's test; the benefits of CNB were calculated. Results: Compared to FNA, CNB and FNA/CNB showed fewer inconclusive diagnoses (FNA vs. CNB: 62/147 [42.2%] vs. 14/147 [9.5%], p<0.001; FNA vs. FNA/CNB: 62/147 [42.2%] vs. 14/147 [9.5%], p<0.001), resulting in the avoidance of repeat FNA or diagnostic surgery in 48 of 62 patients (77.4%, respectively in CNB and FNA/CNB) who would have undergone these procedures if only FNA was performed. Compared to FNA, FNA/CNB showed higher sensitivity and accuracy (sensitivity: 23/32 [71.9%] vs. 31/32 [96.9%], p=0.008; accuracy: 77/86 [89.5%] vs. 85/86 [98.8%], p=0.008), resulting in avoidance of delayed surgery in eight of nine patients (88.9%) with thyroid cancer in whom the surgery would have been missed if FNA only had been performed. Conclusion: In the workup of thyroid nodules with macrocalcification, compared with FNA alone, FNA/CNB decreases inconclusive diagnoses and increases sensitivity, thereby reducing repeated FNA procedures, diagnostic surgeries, and delayed therapeutic surgeries.

AB - Background: This study was performed to determine the benefits of core needle biopsy (CNB), as compared with fine-needle aspiration (FNA), for the diagnosis of thyroid nodules with macrocalcifications. Materials and Methods: The institutional review board approved this retrospective study, and informed consent was waived. From February 2010 to March 2012, the study included 147 thyroid nodules with macrocalcification of 145 consecutive patients who underwent simultaneous FNA and CNB for each nodule. Diagnostic accuracy and inconclusive diagnoses, including nondiagnostic reading and atypia of undetermined significance or follicular lesion of undetermined significance reading were compared among FNA, CNB, and a combination of FNA and CNB (FNA/CNB) using McNemar's test; the benefits of CNB were calculated. Results: Compared to FNA, CNB and FNA/CNB showed fewer inconclusive diagnoses (FNA vs. CNB: 62/147 [42.2%] vs. 14/147 [9.5%], p<0.001; FNA vs. FNA/CNB: 62/147 [42.2%] vs. 14/147 [9.5%], p<0.001), resulting in the avoidance of repeat FNA or diagnostic surgery in 48 of 62 patients (77.4%, respectively in CNB and FNA/CNB) who would have undergone these procedures if only FNA was performed. Compared to FNA, FNA/CNB showed higher sensitivity and accuracy (sensitivity: 23/32 [71.9%] vs. 31/32 [96.9%], p=0.008; accuracy: 77/86 [89.5%] vs. 85/86 [98.8%], p=0.008), resulting in avoidance of delayed surgery in eight of nine patients (88.9%) with thyroid cancer in whom the surgery would have been missed if FNA only had been performed. Conclusion: In the workup of thyroid nodules with macrocalcification, compared with FNA alone, FNA/CNB decreases inconclusive diagnoses and increases sensitivity, thereby reducing repeated FNA procedures, diagnostic surgeries, and delayed therapeutic surgeries.

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