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Thyroid nodules with initially non-diagnostic, fine-needle aspiration results: comparison of core-needle biopsy and repeated fine-needle aspiration.

Abstract：

OBJECTIVE:To evaluate the role of core-needle biopsy (CNB) by comparing the results of CNB and repeated fine-needle aspiration (FNA) for thyroid nodules with initially non-diagnostic FNA results. METHODS:From October 2008 to December 2011, 360 nodules - 180 consecutive repeated FNAs and 180 consecutive CNBs -- from 360 patients (83 men, 277 women; mean age, 54.4 years) with initially non-diagnostic FNA results were analyzed retrospectively. The incidence of non-diagnostic results, inconclusive results, diagnostic surgery, and diagnostic performance of repeated FNA and CNB were assessed, and factors affecting second non-diagnostic results were evaluated. RESULTS:CNB achieved a significantly lower non-diagnostic and inconclusive rate than repeated FNA (1.1 % versus 40.0 %, P < 0.001; 7.2 % versus 72.0 %, P < 0.001). All diagnostic performances with CNB were higher than repeated FNA. The diagnostic surgery rate was lower with CNB than with repeated FNA (3.6 % versus 16.7 %, P = 0.047). Multivariate logistic regression analysis showed that repeated FNA was the most important factor for second non-diagnostic results (OR = 56.06, P < 0.001), followed by nodules with rim calcification (OR = 7.46, P = 0.003). CONCLUSIONS:CNB is more useful than repeated FNA for reducing the number of non-diagnostic and inconclusive results and for preventing unnecessary diagnostic surgery for thyroid nodules with initially non-diagnostic FNA results. KEY POINTS:• Core-needle biopsy achieved a lower number of non-diagnostic and inconclusive results. • Core-needle biopsy achieved better diagnostic performance. • Use of core-needle biopsy could prevent unnecessary diagnostic surgery. • Repeated fine-needle aspiration was significantly associated with a second non-diagnosis.

journal_name

Eur Radiol

journal_title

European radiology

authors

Choi SH,Baek JH,Lee JH,Choi YJ,Hong MJ,Song DE,Kim JK,Yoon JH,Kim WB

doi

10.1007/s00330-014-3325-4

subject

Has Abstract

pub_date

2014-11-01 00:00:00

pages

2819-26

issue

eissn

0938-7994

issn

1432-1084

journal_volume

pub_type

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Thyroid nodules with initially non-diagnostic, fine-needle aspiration results: comparison of core-needle biopsy and repeated fine-needle aspiration.