Ultrasound-Guided Core Needle Biopsy versus Fine-Needle Aspiration Biopsy for Thyroid Nodules
Keywords:Core needle biopsy, Fine needle aspiration biopsy, Thyroid nodule
Objective: The use of core needle biopsy (CNB) may help overcome limitations of fine needle aspiration biopsy (FNAB) for thyroid nodules. The aim of the present study was to compare ultrasound-guided (US-G) CNB with US-G FNAB in terms of diagnostic adequacy based on the 2017 Bethesda System for Reporting Thyroid Cytopathology (the 2017 Bethesda System).
Patients and Methods: A retrospective cohort study of two groups of patients with thyroid nodules who underwent US-G FNAB and CNB at Pakkred Community Hospital between January 1, 2017 to December 31, 2020 was performed. The two groups were compared in terms of diagnostic adequacy.
Results: There were 31 patients in each group. In the CNB group, adequate results in terms of the 2017 Bethesda System were obtained in 77% of patients, while FNAB yielded only 26% adequacy, a statistically significant difference (p < 0.001). Size of the thyroid nodule greater than 2 cm was significantly related to increased adequacy. Cystic or solid or mixed composition of nodules did not significantly impact adequacy.
Conclusion: Ultrasound-guided CNB performed better than FNAB in terms of adequate biopsy results based on the 2017 Bethesda System.
Imruetaicharoenchoke W. Head-neck & breast surgery vol.7: update in thyroid diseases. Vol.7. 1st ed. Bangkok: Bangkok Medical Publisher; 2013.
Cooper DS, Doherty GM, Haugen BR, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009;19:1167-214. doi:10.1089/thy.2009.0110.
Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid 2016;26:1-133. doi:10.1089/thy.2015.0020.
Cibas ES, Ali SZ, NCI Thyroid FNA State of the Science Conference. The Bethesda System for Reporting Thyroid Cytopathology. Am J Clin Pathol 2009;132:658-65. doi:10.1309/AJCPPHLWMI3JV4LA.
Cibas ES, Ali SZ. The 2017 Bethesda System for Reporting Thyroid Cytopathology. Thyroid 2017;27:1341-46. doi:10.1089/thy.2017.0500.
Keelawat S, Rangdaeng S, Koonmee S, et al. Current status of thyroid fine-needle aspiration practice in Thailand. J Pathol Transl Med 2017;51:565-70. doi: 10.4132/jptm.2017.08.12.
Limlunjakorn P, Keelawat S, Bychkov A. Evaluation of thyroid fine needle aspiration cytology by the Bethesda Reporting System: a retrospective analysis of rates and outcomes from the King Chulalongkorn Memorial Hospital. J Med Assoc Thai 2017;100:783-92.
Ahn SH, Seo M, Ha SM, et al. Comparison of the diagnostic efficacy of ultrasound-guided core needle biopsy with 18- versus 20-gauge needles for thyroid nodules. J Ultrasound Med 2018;37:2565-74. doi:10.1002/jum.14614.
Choi SH, Baek JH, Lee JH, et al. Thyroid nodules with initially non-diagnostic, fine-needle aspiration results: comparison of core-needle biopsy and repeated fine-needle aspiration. Eur Radiol 2014;24:2819-26. doi:10.1007/s00330-014-3325-4.
Hahn SY, Shin JH, Oh YL, et al. Comparison between fine needle aspiration and core needle biopsy for the diagnosis of thyroid nodules: effective indications according to US finding. Sci Rep 2020;10:4969. doi:10.1038/s41598-020-60872-z.
Jung CK, Baek JH. Recent advances in core needle biopsy for thyroid nudules. Endocrinol Metab 2017;32:407-12. doi:10.3803/EnM.2017.32.4.407.
Jung CK, Baek JH, Na DG, et al. 2019 Practice guidelines for core needle biopsy: a report of the Clinical Practice Guidelines Development Committee of the Korean Thyroid Association. J Pathol Transl Med 2020;54:64-86. doi:10.4132/jptm.2019.12.04.
Paja M, Del Cura JL, Zabala R, et al. Core-needle biopsy in thyroid nodules: performance, accuracy, and complications. Eur Radiol 2019;29:4889-96. doi:10.1007/s00330-019-06038-6.
Screaton NJ, Berman LH, Grant JW. US-guided core-needle biopsy of the thyroid gland. Radiology 2003;226:827-32. doi:10.1148/radiol.2263012073.
Strauss EB, Lovino A, Upender S. Simultaneous fine-needle aspiration and core biopsy of thyroid nodules and other superficial head and neck masses using sonographic guidance.Am J Roentgenol 2008;190:1697-9. doi:10.2214/AJR.07.3530.
Suh CH, Baek JH, Lee J, et al. The role of core-needle biopsy in the diagnosis of thyroid malignancy in 4580 patients with 4746 thyroid nodules: a systematic review and meta-analysis. Endocrine 2016;54:315-28. doi:10.1007/s12020-016-0991-9.
Suh CH, Baek JH, Park C, et al. The role of core needle biopsy for thyroid nodules with initially indeterminate results on previous fine-needle aspiration: a systematic review and meta-analysis. Am J Neuroradiol 2017;38:1421-26. doi:10.3174/ajnr.A5182.
Trimboli P, Nasrollah N, Guidobaldi L, et al. The use of core needle biopsy as first-line in diagnosis of thyroid nodules reduces false negative and inconclusive data reported by fine-needle aspiration. World J Surg Oncol 2014;12:61. doi:10.1186/1477-7819-12-61.
Wolinski K, Stangierski A, Ruchala M. Comparison of diagnostic yield of core-needle and fine-needle aspiration biopsies of thyroid lesions: Systematic review and meta-analysis. Eur Radiol 2017;27:431-36. doi:10.1007/s00330-016-4356-9.
Jeong EJ, Chung SR, Baek JH, et al. A Comparison of ultrasound-guided fine needle aspiration versus core needle biopsy for thyroid nodules: pain, tolerability, and complications. Endocrinol Metab 2018;33:114-20. doi:10.3803/EnM.2018.33.1.114.
Kim HJ, Kim YK, Moon JH, et al. Thyroid core needle biopsy: patients’ pain and satisfaction compare to fine needle aspiration. Endocrine 2019;65:365-70. doi:10.1007/s12020-019-01973-2.
How to Cite
Copyright (c) 2022 The Royal College of Surgeons of Thailand
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.