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Core-Needle Biopsy Does Not Show Superior Diagnostic Performance to Fine-Needle Aspiration for Diagnosing Thyroid Nodules

Yonsei Medical Journal 2020년 61권 2호 p.161 ~ 168
 ( Shin Il-Ah ) - Yonsei University College of Medicine Severance Hospital Department of Radiology

김은경 ( Kim Eun-Kyung ) - Yonsei University College of Medicine Severance Hospital Department of Radiology
문희정 ( Moon Hee-Jung ) - Yonsei University College of Medicine Severance Hospital Department of Radiology
윤정현 ( Yoon Jung-Hyun ) - Yonsei University College of Medicine Severance Hospital Department of Radiology
박영진 ( Park Vivian Young-Jean ) - Yonsei University College of Medicine Severance Hospital Department of Radiology
이시온 ( Lee Si-Eun ) - Yonsei University College of Medicine Severance Hospital Department of Radiology
이혜선 ( Lee Hye-Sun ) - Yonsei University College of Medicine Biostatistics Collaboration Unit
곽진영 ( Kwak Jin-Young ) - Yonsei University College of Medicine Severance Hospital Department of Radiology

Abstract


Purpose: To compare the diagnostic performances of fine-needle aspiration (FNA) and core-needle biopsy (CNB) for thyroid nodules according to nodule size.

Materials and Methods: This retrospective study included 320 thyroid nodules from 320 patients who underwent both FNA and CNB at outside clinics and proceeded with surgery in our institution between July 2012 and May 2019. According to nodule size, the diagnostic performances of FNA and CNB were calculated using various combinations of test-negatives and test-positives defined by the Bethesda categories and were compared using the generalized estimated equation and the Delong method.

Results: There were 279 malignant nodules in 279 patients and 41 benign nodules in 41 patients. The diagnostic performance of FNA was mostly not different from CNB regardless of nodule size, except for negative predictive value, which was better for FNA than CNB when applying Criteria 1 and 2. When applying Criteria 3, the specificity and positive predictive value of FNA were superior to CNB regardless of size. When applying Criteria 4, diagnostic performance did not differ between FNA and CNB regardless of size. After applying Criteria 5, diagnostic performance did not differ between FNA and CNB in nodules ≥2 cm. However, in nodules ≥1 cm and all nodules, the sensitivity, accuracy, and negative predictive value of CNB were better than those of FNA.

Conclusion: CNB did not show superior diagnostic performance to FNA for diagnosing thyroid nodules.

키워드

Ultrasonography; biopsy, fine-needle; thyroid neoplasms; biopsy, large-core needle
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