Head and Neck

European Radiology

, Volume 22, Issue 7, pp 1564-1572

Diagnostic accuracy of fine-needle aspiration versus core-needle biopsy for the diagnosis of thyroid malignancy in a clinical cohort

  • Jin Yong SungAffiliated withDepartment of Radiology, Thyroid Center, Daerim St. Mary’s Hospital
  • , Dong Gyu NaAffiliated withDepartment of Radiology, Human Medical Imaging and Intervention Center Email author 
  • , Kyu Sun KimAffiliated withDepartment of Radiology, Thyroid Center, Daerim St. Mary’s Hospital
  • , Hyunju YooAffiliated withDepartment of Pathology, Thyroid Center, Daerim St. Mary’s Hospital
  • , Hunkyung LeeAffiliated withDepartment of Pathology, Ewha Clinical Laboratory
  • , Ji-hoon KimAffiliated withDepartment of Radiology, Seoul National University Hospital, Seoul National University College of Medicine
  • , Jung Hwan BaekAffiliated withDepartment of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine

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Abstract

Objectives

To retrospectively compare the accuracy of fine-needle aspiration (FNA) and core-needle biopsy (CNB) for the diagnosis of thyroid malignancy

Methods

We evaluated the results of FNA and CNB in 555 consecutive thyroid nodules with final diagnoses (malignancy 318, benign 237). All patients underwent FNA and CNB simultaneously for each nodule. We assessed the sensitivity, specificity and accuracy of FNA, CNB and FNA/CNB for the diagnosis of thyroid malignancy.

Results

The sensitivity of FNA, CNB and FNA/CNB for thyroid malignancy was 68.6%, 86.8% and 90.6%, specificity 100%, 99.2% and 99.2%, and accuracy 82.0%, 92.1% and 94.2%, respectively. The sensitivity and accuracy of CNB or FNA/CNB for thyroid malignancy were significantly higher than those of FNA (P < 0.001). Compared with CNB alone, FNA/CNB was more accurate for thyroid malignancy only in small nodules less than 1 cm (P < 0.001).

Conclusions

Our clinical cohort data demonstrated that CNB was more accurate for the diagnosis of thyroid malignancy than FNA, and FNA/CNB was more accurate than CNB alone in small thyroid nodules. CNB will play a complementary role in optimal surgical decision-making and the management of thyroid nodules.

Key Points

CNB was more accurate for the diagnosis of malignancy than FNA.

Combined FNA/CNB was more accurate than CNB alone in small thyroid nodules.

CNB should play at least a complementary role in managing thyroid nodules.

Keywords

Thyroid Ultrasound Aspiration cytology Biopsy Thyroid cancer