Core-needle biopsy versus repeat fine-needle aspiration for thyroid nodules initially read as atypia/follicular lesion of undetermined significance

Head Neck. 2017 Feb;39(2):361-369. doi: 10.1002/hed.24597. Epub 2016 Oct 5.

Abstract

Background: The purpose of this study was to evaluate the role of core-needle biopsy (CNB) by comparing the results of CNB and repeat fine-needle aspiration (FNA) for thyroid nodules that are initially read as atypia/follicular lesion of undetermined significance (AUS/FLUS) on FNA.

Methods: Among 2631 initial AUS/FLUS FNA results, 505 consecutive nodules (295 repeat FNAs and 210 CNBs) were retrospectively analyzed. The primary outcome was inconclusive (ie, nondiagnostic or AUS/FLUS). The secondary outcomes included inconclusive results of the subcategory, risk factors for inconclusive results, and diagnostic performance.

Results: CNB demonstrated significantly fewer inconclusive results than repeat FNA for the overall nodules (40.9% vs 63%; p < .001). Repeat FNA and group FLUS were significant risk factors for inconclusive results (odds ratio = 1.92; p =.001 and odds ratio = 2.08; p <.001, respectively). All diagnostic performances using CNB were higher than repeat FNAs.

Conclusion: CNB is more useful than repeat FNAs for reducing inconclusive results and improving the diagnostic performance of thyroid nodules with initial AUS/FLUS FNA results. © 2016 Wiley Periodicals, Inc. Head Neck 39: 361-369, 2017.

Keywords: atypia of undetermined significance; core-needle biopsy; fine-needle aspiration; follicular lesion of undetermined significance; ultrasound.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma, Follicular / pathology*
  • Adenocarcinoma, Follicular / physiopathology
  • Adult
  • Aged
  • Biopsy, Fine-Needle / methods
  • Biopsy, Large-Core Needle / methods
  • Cohort Studies
  • Diagnosis, Differential
  • Female
  • Humans
  • Image-Guided Biopsy / methods*
  • Immunohistochemistry
  • Japan
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Predictive Value of Tests
  • Retrospective Studies
  • Sensitivity and Specificity
  • Thyroid Neoplasms / pathology*
  • Thyroid Neoplasms / physiopathology
  • Thyroid Nodule / pathology*
  • Thyroid Nodule / physiopathology
  • Ultrasonography, Doppler / methods*