Skip to main content
SpringerLink
Log in

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

  • Meta-Analysis
  • Published:
Endocrine Aims and scope Submit manuscript

Abstract

To evaluate the effectiveness and complications of core-needle biopsy (CNB) compared to fine-needle aspiration (FNA) for diagnosing thyroid malignancy. The Ovid-MEDLINE and EMBASE databases were searched for studies using CNB for diagnosing thyroid malignancy. A meta-analysis was performed to evaluate the diagnostic accuracy, the incidence of non-diagnostic, inconclusive results, and the complications of CNB and FNA. To overcome the heterogeneity, additional analyses based on three, homogeneous inclusion criteria were performed and subgroup analyses were performed. Twenty eligible studies of 4580 patients (4746 nodules) were included. Both CNB and FNA demonstrated a high sensitivity (91 %, 74 %, respectively; p = .053) and specificity (99 %, 100 %, respectively; p = .914). The area under the curve was larger in CNB (0.99) than in FNA (0.94). CNB demonstrated a significantly lower pooled proportion of non-diagnostic (5.5 %; p < .001) and inconclusive results (8.0 %; p < .001) than FNA (22.6 %, 40.2 %, respectively). The complications rate of FNA (0.0 %) was lower than that of CNB (0.01 %), although not significantly (p = .948). This meta-analysis showed variable heterogeneities, i.e., no heterogeneity to considerable heterogeneity. Additional meta-analyses based on three, homogeneous inclusion criteria demonstrated that heterogeneities were reduced, and the results are in agreement with those of all of the included studies. Subgroup analyses have explained the cause of heterogeneity across studies. Both CNB and FNA may be acceptable diagnostic tools for diagnosing thyroid malignancy. CNB may be a complementary diagnostic tool in nodules with initially non-diagnostic and indeterminate results on previous FNA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

Abbreviations

US:

Ultrasound

FNA:

Fine-needle aspiration

CNB:

Core-needle biopsy

References

  1. Y.H. Lee, J.H. Baek, S.L. Jung, J.Y. Kwak, J.H. Kim, J.H. Shin, Ultrasound-guided fine needle aspiration of thyroid nodules: a consensus statement by the korean society of thyroid radiology. Korean J Radiol 16(2), 391–401 (2015)

    Article  PubMed  PubMed Central  Google Scholar 

  2. Z.W. Baloch, E.S. Cibas, D.P. Clark, L.J. Layfield, B.M. Ljung, M.B. Pitman, A. Abati, The National Cancer Institute Thyroid fine needle aspiration state of the science conference: a summation. CytoJournal 5, 6 (2008)

    Article  PubMed  PubMed Central  Google Scholar 

  3. M.B. Pitman, J. Abele, S.Z. Ali, D. Duick, T.M. Elsheikh, R.B. Jeffrey, C.N. Powers, G. Randolph, A. Renshaw, L. Scoutt, Techniques for thyroid FNA: a synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference. Diagn Cytopathol 36(6), 407–424 (2008)

    Article  PubMed  Google Scholar 

  4. D.S. Cooper, G.M. Doherty, B.R. Haugen, B.R. Hauger, R.T. Kloos, S.L. Lee, S.J. Mandel, E.L. Mazzaferri, B. McIver, F. Pacini, M. Schlumberger, S.I. Sherman, D.L. Steward, R.M. Tuttle, Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 19(11), 1167–1214 (2009)

    Article  PubMed  Google Scholar 

  5. H. Gharib, E. Papini, R. Paschke, D.S. Duick, R. Valcavi, L. Hegedus, P. Vitti, American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr Pract 16(Suppl 1), 1–43 (2010)

    Article  PubMed  Google Scholar 

  6. E.K. Alexander, J.P. Heering, C.B. Benson, M.C. Frates, P.M. Doubilet, E.S. Cibas, E. Marqusee, Assessment of nondiagnostic ultrasound-guided fine needle aspirations of thyroid nodules. J Clin Endocrinol Metab 87(11), 4924–4927 (2002)

    Article  CAS  PubMed  Google Scholar 

  7. S. Taki, K. Kakuda, K. Kakuma, Y. Annen, S. Katada, R. Yamashita, M. Kosugi, T. Michigishi, N. Tonami, Thyroid nodules: evaluation with US-guided core biopsy with an automated biopsy gun. Radiology 202(3), 874–877 (1997)

    Article  CAS  PubMed  Google Scholar 

  8. S. Karstrup, E. Balslev, N. Juul, P.C. Eskildsen, L. Baumbach, US-guided fine needle aspiration versus coarse needle biopsy of thyroid nodules. Eur J Ultrasound 13(1), 1–5 (2001)

    Article  CAS  PubMed  Google Scholar 

  9. N.J. Screaton, L.H. Berman, J.W. Grant, US-guided core-needle biopsy of the thyroid gland. Radiology 226(3), 827–832 (2003)

    Article  PubMed  Google Scholar 

  10. J.N. Harvey, D. Parker, P. De, R.K. Shrimali, M. Otter, Sonographically guided core biopsy in the assessment of thyroid nodules. J Clin Ultrasound 33(2), 57–62 (2005)

    Article  PubMed  Google Scholar 

  11. A.A. Renshaw, N. Pinnar, Comparison of thyroid fine-needle aspiration and core needle biopsy. Am J Clin Pathol 128(3), 370–374 (2007)

    Article  PubMed  Google Scholar 

  12. S. Zhang, M. Ivanovic, A.A. Nemcek, D.V. Defrias, E. Lucas, R. Nayar, Thin core needle biopsy crush preparations in conjunction with fine-needle aspiration for the evaluation of thyroid nodules: a complementary approach. Cancer 114(6), 512–518 (2008)

    Article  PubMed  Google Scholar 

  13. K.T. Park, S.H. Ahn, J.H. Mo, Y.J. Park, J. Park do, S.I. Choi, S.Y. Park, Role of core needle biopsy and ultrasonographic finding in management of indeterminate thyroid nodules. Head & Neck 33(2), 160–165 (2011)

    Article  Google Scholar 

  14. A.E. Samir, A. Vij, M.K. Seale, G. Desai, E. Halpern, W.C. Faquin, S. Parangi, P.F. Hahn, G.H. Daniels, Ultrasound-guided percutaneous thyroid nodule core biopsy: clinical utility in patients with prior nondiagnostic fine-needle aspirate. Thyroid 22(5), 461–467 (2012)

    Article  PubMed  PubMed Central  Google Scholar 

  15. J.Y. Sung, D.G. Na, K.S. Kim, H. Yoo, H. Lee, J.H. Kim, J.H. Baek, Diagnostic accuracy of fine-needle aspiration versus core-needle biopsy for the diagnosis of thyroid malignancy in a clinical cohort. European Radiol 22(7), 1564–1572 (2012)

    Article  Google Scholar 

  16. E.J. Ha, J.H. Baek, J.H. Lee, D.E. Song, J.K. Kim, Y.K. Shong, S.J. Hong, Sonographically suspicious thyroid nodules with initially benign cytologic results: the role of a core needle biopsy. Thyroid 23(6), 703–708 (2013)

    Article  PubMed  Google Scholar 

  17. S.Y. Hahn, J.H. Shin, B.K. Han, E.Y. Ko, E.S. Ko, Ultrasonography-guided core needle biopsy for the thyroid nodule: does the procedure hold any benefit for the diagnosis when fine-needle aspiration cytology analysis shows inconclusive results? Br J Radiol 86(1025), 20130007 (2013)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. N. Nasrollah, P. Trimboli, L. Guidobaldi, D.D. CicciarellaModica, C. Ventura, G. Ramacciato, S. Taccogna, F. Romanelli, S. Valabrega, A. Crescenzi, Thin core biopsy should help to discriminate thyroid nodules cytologically classified as indeterminate. A new sampling technique. Endocrine 43(3), 659–665 (2013)

    Article  CAS  PubMed  Google Scholar 

  19. S.H. Choi, J.H. Baek, J.H. Lee, Y.J. Choi, M.J. Hong, D.E. Song, J.K. Kim, J.H. Yoon, W.B. Kim, Thyroid nodules with initially non-diagnostic, fine-needle aspiration results: comparison of core-needle biopsy and repeated fine-needle aspiration. Eur Radiol 24(11), 2819–2826 (2014)

    Article  PubMed  Google Scholar 

  20. Y.J. Choi, J.H. Baek, E.J. Ha, H.K. Lim, J.H. Lee, J.K. Kim, D.E. Song, Y.K. Shong, S.J. Hong, Differences in risk of malignancy and management recommendations in subcategories of thyroid nodules with atypia of undetermined significance or follicular lesion of undetermined significance: the role of ultrasound-guided core-needle biopsy. Thyroid 24(3), 494–501 (2014)

    Article  PubMed  Google Scholar 

  21. H. Lee, J.H. Shin, Y.L. Oh, S.Y. Hahn, Atypia of undetermined significance in thyroid fine-needle aspiration cytology: prediction of malignancy by US and comparison of methods for further management. Ann Surg Oncol 21(7), 2326–2331 (2014)

    Article  PubMed  Google Scholar 

  22. S.H. Lee, M.H. Kim, J.S. Bae, D.J. Lim, S.L. Jung, C.K. Jung, Clinical outcomes in patients with non-diagnostic thyroid fine needle aspiration cytology: usefulness of the thyroid core needle biopsy. Ann Surg Oncol 21(6), 1870–1877 (2014)

    Article  PubMed  Google Scholar 

  23. P. Trimboli, N. Nasrollah, L. Guidobaldi, S. Taccogna, D.D. Cicciarella Modica, S. Amendola, F. Romanelli, A. Lenzi, G. Nigri, M. Centanni, L. Giovanella, S. Valabrega, A. Crescenzi, 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 12, 61 (2014)

    Article  PubMed  PubMed Central  Google Scholar 

  24. W.S. Yoo, H.S. Choi, S.W. Cho, J.H. Moon, K.W. Kim, H.J. Park, S.Y. Park, S.I. Choi, S.H. Choi, S. Lim, K.H. Yi, J. Park do, H.C. Jang, Y.J. Park, The role of ultrasound findings in the management of thyroid nodules with atypia or follicular lesions of undetermined significance. Clin Endocrinol 80(5), 735–742 (2014)

    Article  Google Scholar 

  25. M. Zhang, Y. Zhang, S. Fu, F. Lv, J. Tang, Thyroid nodules with suspicious ultrasound findings: the role of ultrasound-guided core needle biopsy. Clin Imaging 38(4), 434–438 (2014)

    Article  PubMed  Google Scholar 

  26. B.T. Chen, A.B. Jain, A. Dagis, P. Chu, L. Vora, E. Maghami, B. Salehian, Comparison of the efficacy and safety of ultrasound-guided core needle biopsy versus fine-needle aspiration for evaluating thyroid nodules. Endocr Pract 21(2), 128–135 (2015)

    Article  PubMed  Google Scholar 

  27. N. Nasrollah, P. Trimboli, F. Rossi, S. Amendola, L. Guidobaldi, C. Ventura, R. Maglio, G. Nigri, F. Romanelli, S. Valabrega, A. Crescenzi, Patient’s comfort with and tolerability of thyroid core needle biopsy. Endocrine 45(1), 79–83 (2014)

    Article  CAS  PubMed  Google Scholar 

  28. K.T. Park, S.H. Ahn, J.H. Mo, Y.J. Park, J. Park do, S.I. Choi, S.Y. Park, Role of core needle biopsy and ultrasonographic finding in management of indeterminate thyroid nodules. Head & Neck 33(2), 160–165 (2011)

    Article  Google Scholar 

  29. T. Hakala, I. Kholova, J. Sand, R. Saaristo, P. Kellokumpu-Lehtinen, A core needle biopsy provides more malignancy-specific results than fine-needle aspiration biopsy in thyroid nodules suspicious for malignancy. J Clin Pathol 66(12), 1046–1050 (2013)

    Article  CAS  PubMed  Google Scholar 

  30. E. Novoa, N. Gurtler, A. Arnoux, M. Kraft, Role of ultrasound-guided core-needle biopsy in the assessment of head and neck lesions: a meta-analysis and systematic review of the literature. Head & Neck 34(10), 1497–1503 (2012)

    Article  Google Scholar 

  31. T.K. Khoo, C.H. Baker, J. Hallanger-Johnson, A.M. Tom, C.S. Grant, C.C. Reading, T.J. Sebo, J.C. Morris 3rd, Comparison of ultrasound-guided fine-needle aspiration biopsy with core-needle biopsy in the evaluation of thyroid nodules. Endocr Pract 14(4), 426–431 (2008)

    Article  PubMed  Google Scholar 

  32. L. Li, B.D. Chen, H.F. Zhu, S. Wu, D. Wei, J.Q. Zhang, L. Yu, Comparison of pre-operation diagnosis of thyroid cancer with fine needle aspiration and core-needle biopsy: a meta-analysis. Asian Pacific J Cancer Prevent 15(17), 7187–7193 (2014)

    Article  Google Scholar 

  33. P. Trimboli, A. Crescenzi, Thyroid core needle biopsy: taking stock of the situation. Endocrine 48(3), 779–785 (2015)

    Article  CAS  PubMed  Google Scholar 

  34. J.H. Yoon, E.K. Kim, J.Y. Kwak, H.J. Moon, Effectiveness and limitations of core needle biopsy in the diagnosis of thyroid nodules: review of current literature. J Pathol Transl Med 49(3), 230–235 (2015)

    Article  PubMed  PubMed Central  Google Scholar 

  35. D.G. Na, J.H. Kim, J.Y. Sung, J.H. Baek, K.C. Jung, H. Lee, H. Yoo, Core-needle biopsy is more useful than repeat fine-needle aspiration in thyroid nodules read as nondiagnostic or atypia of undetermined significance by the bethesda system for reporting thyroid cytopathology. Thyroid 22(5), 468–475 (2012)

    Article  PubMed  Google Scholar 

  36. C.K. Jung, H.S. Min, H.J. Park, D.E. Song, J.H. Kim, S.Y. Park, H. Yoo, M.K. Shin, Pathology Reporting of Thyroid Core Needle Biopsy: a Proposal of the Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Group. J Pathol Transl Med 49(4), 288–299 (2015)

    Article  PubMed  PubMed Central  Google Scholar 

  37. E.S. Cibas, S.Z. Ali, The Bethesda system for reporting thyroid cytopathology. Am J Clin Pathol 132(5), 658–665 (2009)

    Article  PubMed  Google Scholar 

  38. J.S. Yeon, J.H. Baek, H.K. Lim, E.J. Ha, J.K. Kim, D.E. Song, T.Y. Kim, J.H. Lee, Thyroid nodules with initially nondiagnostic cytologic results: the role of core-needle biopsy. Radiology 268(1), 274–280 (2013)

    Article  PubMed  Google Scholar 

  39. P. Whiting, A.W. Rutjes, J.B. Reitsma, P.M. Bossuyt, J. Kleijnen, The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol 3, 25 (2003)

    Article  PubMed  PubMed Central  Google Scholar 

  40. C.H. Suh, S.H. Park, Successful publication of systematic review and meta-analysis of studies evaluating diagnostic test accuracy. Korean J Radiol 17(1), 5–6 (2016)

    Article  PubMed  PubMed Central  Google Scholar 

  41. K.W. Kim, J. Lee, S.H. Choi, J. Huh, S.H. Park, Systematic review and meta-analysis of studies evaluating diagnostic test accuracy: a practical review for clinical researchers-part I. General guidance and tips. Korean J Radiol 16(6), 1175–1187 (2015)

    Article  PubMed  PubMed Central  Google Scholar 

  42. J. Lee, K.W. Kim, S.H. Choi, J. Huh, S.H. Park, Systematic review and meta-analysis of studies evaluating diagnostic test accuracy: a practical review for clinical researchers-part II. Statistical methods of meta-analysis. Korean J Radiol 16(6), 1188–1196 (2015)

    Article  PubMed  PubMed Central  Google Scholar 

  43. P. Lo Gerfo, T. Colacchio, F. Caushaj, C. Weber, C. Feind, Comparison of fine-needle and coarse-needle biopsies in evaluating thyroid nodules. Surgery 92(5), 835–838 (1982)

    CAS  PubMed  Google Scholar 

  44. J.F. Silverman, R.L. West, J.L. Finley, E.W. Larkin, H.K. Park, M.S. Swanson, W.W. Fore, Fine-needle aspiration versus large-needle biopsy or cutting biopsy in evaluation of thyroid nodules. Diagn Cytopathol 2(1), 25–30 (1986)

    Article  CAS  PubMed  Google Scholar 

  45. J.S. Munn, M. Castelli, R.A. Prinz, J.L. Walloch, Needle biopsy of nodular thyroid disease. Am Surg 54(7), 438–443 (1988)

    CAS  PubMed  Google Scholar 

  46. Q. Liu, M. Castelli, P. Gattuso, R.A. Prinz, Simultaneous fine-needle aspiration and core-needle biopsy of thyroid nodules. Am Surg 61(7), 628–632 (1995). discussion 632–623

    CAS  PubMed  Google Scholar 

  47. J.D. Oppenheimer, D. Kasuganti, R. Nayar, H.B. Chrisman, R.J. Lewandowski, A.A. Nemcek Jr., R.K. Ryu, How to interpret thyroid biopsy results: a three-year retrospective interventional radiology experience. Cardiovasc Interv Radiol 33(4), 800–805 (2010)

    Article  Google Scholar 

  48. A. Stangierski, K. Wolinski, K. Martin, O. Leitgeber, M. Ruchala, Core needle biopsy of thyroid nodules—evaluation of diagnostic utility and pain experience. Neuro Endocrinol Lett 34(8), 798–801 (2013)

    PubMed  Google Scholar 

  49. T. Pisani, M. Bononi, C. Nagar, M. Angelini, M. Bezzi, A. Vecchione, Fine needle aspiration and core needle biopsy techniques in the diagnosis of nodular thyroid pathologies. Anticancer Res 20(5c), 3843–3847 (2000)

    CAS  PubMed  Google Scholar 

  50. H.S. Min, J.H. Kim, I. Ryoo, S.L. Jung, C.K. Jung, The role of core needle biopsy in the preoperative diagnosis of follicular neoplasm of the thyroid. APMIS 122(10), 993–1000 (2014)

    Article  PubMed  Google Scholar 

  51. P. Lo Gerfo, The value of coarse needle biopsy in evaluating thyroid nodules. Thyroidology 6(1), 1–4 (1994)

    CAS  PubMed  Google Scholar 

  52. D. Lieu, Cytopathologist-performed ultrasound-guided fine-needle aspiration and core-needle biopsy: a prospective study of 500 consecutive cases. Diagn Cytopathol 36(5), 317–324 (2008)

    Article  PubMed  Google Scholar 

  53. E.J. Ha, J.H. Baek, J.H. Lee, J.K. Kim, J.K. Kim, H.K. Lim, D.E. Song, T.Y. Sung, T.Y. Kim, W.B. Kim, Y.K. Shong, Core needle biopsy can minimise the non-diagnostic results and need for diagnostic surgery in patients with calcified thyroid nodules. Eur Radiol 24(6), 1403–1409 (2014)

    Article  PubMed  Google Scholar 

  54. E.J. Ha, J.H. Baek, J.H. Lee, Ultrasonography-based thyroidal and perithyroidal anatomy and its clinical significance. Korean J Radiol 16(4), 749–766 (2015)

    Article  PubMed  PubMed Central  Google Scholar 

  55. A. Crescenzi, P. Trimboli, D.C. Modica, C. Taffon, L. Guidobaldi, S. Taccogna, A. Rainer, M. Trombetta, E. Papini, G. Zelano, Preoperative assessment of TERT promoter mutation on thyroid core needle biopsies supports diagnosis of malignancy and addresses surgical strategy. Horm Metab Res 48(3), 157–162 (2016)

    CAS  PubMed  Google Scholar 

  56. S.H. Choi, K.H. Han, J.H. Yoon, H.J. Moon, E.J. Son, J.H. Youk, E.K. Kim, J.Y. Kwak, Factors affecting inadequate sampling of ultrasound-guided fine-needle aspiration biopsy of thyroid nodules. Clin Endocrinol 74(6), 776–782 (2011)

    Article  Google Scholar 

  57. K.S. Yi, J.H. Kim, D.G. Na, H. Seo, H.S. Min, J.K. Won, T.J. Yun, I. Ryoo, S.C. Kim, S.H. Choi, C.H. Sohn, Usefulness of core needle biopsy for thyroid nodules with macrocalcifications: comparison with fine-needle aspiration. Thyroid 25(6), 657–664 (2015)

    Article  PubMed  PubMed Central  Google Scholar 

  58. R.G. Yoon, J.H. Baek, J.H. Lee, Y.J. Choi, M.J. Hong, D.E. Song, J.K. Kim, J.H. Yoon, W.B. Kim, Diagnosis of thyroid follicular neoplasm: fine-needle aspiration versus core-needle biopsy. Thyroid 24(11), 1612–1617 (2014)

    Article  PubMed  Google Scholar 

  59. E.J. Ha, J.H. Baek, D.G. Na, J.H. Kim, J.K. Kim, H.S. Min, D.E. Song, K.E. Lee, Y.K. Shong, The role of core needle biopsy and its impact on surgical management in patients with medullary thyroid cancer: clinical experience at 3 medical institutions. AJNR 36, 1512–1517 (2015)

    Article  CAS  PubMed  Google Scholar 

  60. M. Nam, J.H. Shin, B.K. Han, E.Y. Ko, E.S. Ko, S.Y. Hahn, J.H. Chung, Y.L. Oh, Thyroid lymphoma: correlation of radiologic and pathologic features. J Ultrasound Med 31(4), 589–594 (2012)

    PubMed  Google Scholar 

  61. J.Y. Kwak, E.K. Kim, K.H. Ko, W.I. Yang, M.J. Kim, E.J. Son, K.K. Oh, K.W. Kim, Primary thyroid lymphoma: role of ultrasound-guided needle biopsy. J Ultrasound Med 26(12), 1761–1765 (2007)

    PubMed  Google Scholar 

  62. K. Buxey, J. Serpell, Importance of core biopsy in the diagnosis of thyroid lymphoma. ANZ J Surg 82(1–2), 90 (2012)

    Article  PubMed  Google Scholar 

  63. A. Liberati, D.G. Altman, J. Tetzlaff, C. Mulrow, P.C. Gøtzsche, J.P. Ioannidis, M. Clarke, P.J. Devereaux, J. Kleijnen, D. Moher, The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 6(7), e1000100 (2009)

    Article  PubMed  PubMed Central  Google Scholar 

  64. J.J. Deeks, P.M. Bossuyt, C. Gatsonis, Cochrane handbook for systematic reviews of diagnostic test accuracy version 1.0.0. The Cochrane Collaboration. http://srdta.cochrane.org/handbook-dta-reviews (2013). Accessed 16 June 2015

Download references

Author information

Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 138-736, Republic of Korea

    Chong Hyun Suh, Jung Hwan Baek, Jeong Hyun Lee, Young Jun Choi & Kyung Won Kim

  2. Department of Radiology, Namwon Medical Center, 365 Chungjeong-Ro, Namwon-Si, Jeollabuk-Do, 590-702, Republic of Korea

    Chong Hyun Suh

  3. National Evidence-based Healthcare Collaborating Agency, Seoul, Republic of Korea

    Jayoun Lee

  4. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 138-736, Republic of Korea

    Ki-Wook Chung

  5. Department of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 138-736, Republic of Korea

    Young Kee Shong

Authors
  1. Chong Hyun Suh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jung Hwan Baek
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jeong Hyun Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Young Jun Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kyung Won Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jayoun Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ki-Wook Chung
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Young Kee Shong
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jung Hwan Baek.

Ethics declarations

Disclosure

No competing financial interests exist.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 30 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Suh, C.H., Baek, J.H., Lee, J.H. 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 54, 315–328 (2016). https://doi.org/10.1007/s12020-016-0991-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12020-016-0991-9

Keywords

Search

Navigation