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Core needle biopsy can minimise the non-diagnostic results and need for diagnostic surgery in patients with calcified thyroid nodules

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Abstract

Purpose

To evaluate the role of core needle biopsy (CNB) for calcified thyroid nodules.

Methods

Between October 2008 and July 2011, 264 patients underwent ultrasound-guided CNB for 272 calcified thyroid nodules at our institution. We retrospectively evaluated the incidence of technical failure, non-diagnostic readings, and the diagnostic performance of CNB, and analysed the relationship between the types of calcification and the CNB results. Finally, the incidence of diagnostic surgery was calculated.

Results

The incidence of technical failure was 1.1 % (3/275) and that of non-diagnostic results was 0.7 % (2/272). The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of CNB were 94.7 %, 89.5 %, 100 %, 100 %, and 90.2 %, respectively. There were no significant differences according to the calcification subtype for either the non-diagnostic results or the incidence of technical failure (P > 0.99 and P > 0.99). CNB could prevent diagnostic surgery for 92.9 % (13/14) of the patients who showed more than two non-diagnostic results in previous FNA.

Conclusions

CNB can minimise the non-diagnostic results as well as diagnostic surgery in patients with calcified thyroid nodules. Therefore, CNB may be used as a first-line diagnostic tool for calcified thyroid nodules rather than FNA.

Key points

• CNB results show the low incidence of technical failure (1.1 %, 3/275).

• CNB results show the low non-diagnostic rate (0.7 %, 2/272).

• There were no significant differences according to the calcification subtype.

• CNB can prevent unnecessary diagnostic surgery in 92.9 % (13/14).

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Abbreviations

US:

ultrasound

FNA:

fine-needle aspiration

CNB:

core-needle biopsy

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Acknowledgements

The scientific guarantor of this publication is Jung Hwan Baek. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. The institutional review board approved this retrospective study and required neither patient approval nor informed consent for review of the images and medical records. However, informed consent for FNA or CNB was obtained from all patients prior to biopsy. We would like to mention that some calcified nodules (n = 76) in this study have been reported in a previously published article (Yeon JS, Baek JH, Lim HK, et al. (2013) Thyroid Nodules with Initially Nondiagnostic Cytologic Results: The Role of Core-Needle Biopsy. Radiology, 268(1):274–280) which evaluated the role of CNB in thyroid nodules with initially nondiagnostic cytological results. That was resulted from a high incidence of nondiagnostic FNA results in calcified nodules. However, we believe that our study results provide valuable information and options for both clinicians and patients to avoid unnecessary diagnostic surgery. Methodology: retrospective, case–control and single-centre study.

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Authors and Affiliations

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

    Eun Ju Ha, Jung Hwan Baek, Jeong Hyun Lee, Jin Kyoung Kim & Hyun Kyung Lim

  2. Department of Radiology, Ajou University School of Medicine, Wonchon-Dong, Yeongtong-Gu, Suwon, 443-380, Korea

    Eun Ju Ha

  3. Department of Radiology, Chung-Ang University College of Medicine, 224-1 Heukseokdong, Dongjak-gu, Seoul, 156-755, Korea

    Jae Kyun Kim

  4. Department of Radiology, Soonchunhyang University Hospital, 59, Daesagwan-Ro, Yongsan-Gu, Seoul, 140-887, Korea

    Hyun Kyung Lim

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

    Dong Eun Song

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

    Tae Yon Sung

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

    Tae Yong Kim, Won Bae Kim & Young Kee Shong

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  1. Eun Ju Ha
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  2. Jung Hwan Baek
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Correspondence to Jung Hwan Baek.

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Ha, E.J., Baek, J.H., Lee, J.H. et al. Core needle biopsy can minimise the non-diagnostic results and need for diagnostic surgery in patients with calcified thyroid nodules. Eur Radiol 24, 1403–1409 (2014). https://doi.org/10.1007/s00330-014-3123-z

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  • DOI: https://doi.org/10.1007/s00330-014-3123-z

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