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The role of core needle biopsy in the diagnosis of initially detected thyroid nodules: a systematic review and meta-analysis

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Abstract

Objectives

To systematically review the published literature and evaluate the efficacy and safety of core needle biopsy (CNB) for initially detected thyroid nodules.

Methods

The Ovid-MEDLINE and Embase databases were searched for studies evaluating CNB for the diagnosis of initially detected thyroid nodules. A meta-analysis was performed to evaluate non-diagnostic results, inconclusive results and diagnostic accuracy for a diagnosis of malignancy with CNB. To overcome heterogeneity, multiple subgroup analyses were performed. The complication rate was also evaluated.

Results

Thirteen eligible studies, which included a total sample size of 9,166 patients with 13,585 nodules, were included. The pooled proportions were 3.5% (95% CI 2.4–5.1) for non-diagnostic results and 13.8% (95% CI 9.1–20.3) for inconclusive results. Considerable heterogeneity was observed among the studies in terms of the pooled proportions for CNB (I2=92.9%, 97%). With regard to the diagnostic performance for malignancy, the sensitivity was 80% (95% CI 75–85) and the specificity was 100% (95% CI 93–100). Only two major complications of CNB were observed.

Conclusions

CNB demonstrates a low non-diagnostic result rate and high diagnostic accuracy for initially detected thyroid nodules and a low major complication rate. These findings indicate that CNB may be a feasible diagnostic tool for patients with initially detected thyroid nodules.

Key Points

  • CNB demonstrates high diagnostic accuracy for initially detected thyroid nodules.

  • CNB demonstrates a low major complication rate.

  • CNB may be a feasible diagnostic tool for patients with initially detected thyroid nodules.

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Abbreviations

AUS:

Atypia of undetermined significance

CNB:

Core needle biopsy

FNA:

Fine needle aspiration

US:

Ultrasound

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Author notes

  1. Sae Rom Chung and Chong Hyun Suh contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea

    Sae Rom Chung, Jung Hwan Baek, Young Jun Choi & Jeong Hyun Lee

  2. Department of Radiology, Namwon Medical Center, Namwon-si, Jeollabuk-do, Republic of Korea

    Chong Hyun Suh

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  1. Sae Rom Chung
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Correspondence to Jung Hwan Baek.

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Chung, S.R., Suh, C.H., Baek, J.H. et al. The role of core needle biopsy in the diagnosis of initially detected thyroid nodules: a systematic review and meta-analysis. Eur Radiol 28, 4909–4918 (2018). https://doi.org/10.1007/s00330-018-5494-z

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  • DOI: https://doi.org/10.1007/s00330-018-5494-z

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