Complications following ultrasound-guided core needle biopsy of thyroid nodules: a systematic review and meta-analysis
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To identify the complication rate associated with US-guided core needle biopsy (CNB) of thyroid lesions using a systematic review and meta-analysis.
Ovid-MEDLINE and EMBASE databases were searched for studies on US-guided CNB of thyroid lesions from 1 January 1994–13 December 2016. A review of 393 potential papers identified 39 eligible papers including 14,818 patients. The pooled proportions of complications were assessed using random-effects modelling. Subgroup analysis was performed. Among-study heterogeneity was explored using χ2 statistic for pooled estimates and inconsistency index I2. Quality of the studies was evaluated using the Risk of Bias Assessment Tool for Nonrandomized Studies.
The pooled proportion of overall complications after CNB of thyroid lesions was 1.11% (95% CI: 0.64–1.51, I2: 87.2%). The pooled proportion of major complications (0.06% [95% CI: 0.02–0.10], I2: 0.0%) was much lower than that of minor complications (1.08%[95% CI: 0.63–1.53], I2: 93.17%). Subgroup analysis revealed no significant differences between studies on Asian versus non-Asian groups (p=0.7769), radiologist versus non-radiologist groups (p=0.8607), nodule size <20 mm versus nodule size ≥20 mm (p=0.1591) groups, CNB versus CNB-plus-FNA groups (p=0.9281) and studies performed before and after 2012 (p=0.6251). The overall quality of the included studies was moderate with all of the studies satisfying five or more of the eight total domains.
Various complications can occur after US-guided CNB of thyroid lesions. However, the procedure is safe, with a low complication rate.
• Various complications occurred after CNB of thyroid lesions, but the pooled complication rate was low (1.11%, I 2 = 87.2%).
• The pooled proportion of major complications (0.06%) was much lower than that of minor complications (1.08%).
• There was no significant differences between studies on Asian vs. non-Asian groups, radiologist vs. non-radiologist groups, nodule size <20 mm vs. nodule size ≥20 mm groups, CNB vs. CNB-plus-FNA groups, or studies performed before 2012 vs. after 2012.
KeywordsCore needle biopsy Meta-analysis Safety Thyroid nodule Ultrasonography
Core needle biopsy
The authors state that this work has not received any funding.
Compliance with ethical standards
The scientific guarantor of this publication is Jung Hwan Baek.
Conflict of interest
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.
Statistics and biometry
Chong Hyun Suh performed statistical analysis for this paper.
Written informed consent was not required for this study because this study was designed as a systematic review with meta-analysis.
Institutional Review Board approval was not required because this study was designed as a systematic review with meta-analysis.
• systematic review with meta-analysis
- 1.Haugen BR, Alexander EK, Bible KC et al (2016) 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 26:1–133CrossRefPubMedPubMedCentralGoogle Scholar
- 3.Gharib H, Papini E, Garber JR et al (2016) American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules--2016 Update. Endocr Pract 22:622–639CrossRefPubMedGoogle Scholar
- 9.Higgins J GS (2011) Cochrane handbook for systematic reviews of interventions. Version 5.1.0. The Cochrane Collaboration. Available from: http://handbook.cochrane.org.
- 17.Hahn SY, Shin JH, Han BK, Ko EY, Ko ES (2013) 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 86:20130007CrossRefPubMedPubMedCentralGoogle Scholar
- 27.Lee SH, Park GS, Jung SL et al (2016) Core-needle biopsy for the preoperative diagnosis of follicular neoplasm in thyroid nodule screening: a validation study. Pathology – Research and PracticeGoogle Scholar
- 31.Na DG, Min HS, Lee H, Won JK, Seo HB, Kim JH (2015) Role of Core Needle Biopsy in the Management of Atypia/Follicular Lesion of Undetermined Significance Thyroid Nodules: Comparison with Repeat Fine-Needle Aspiration in Subcategory Nodules. Eur Thyroid J 4:189–196CrossRefPubMedPubMedCentralGoogle Scholar