Combined fine-needle aspiration with core needle biopsy for assessing thyroid nodules: a more valuable diagnostic method?

IF 2.4 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Ultrasonography Pub Date : 2023-04-01 DOI:10.14366/usg.22112

Zhe Chen, Jia-Jia Wang, Dong-Ming Guo, Yu-Xia Zhai, Zhuo-Zhi Dai, Hong-Hui Su

{"title":"Combined fine-needle aspiration with core needle biopsy for assessing thyroid nodules: a more valuable diagnostic method?","authors":"Zhe Chen, Jia-Jia Wang, Dong-Ming Guo, Yu-Xia Zhai, Zhuo-Zhi Dai, Hong-Hui Su","doi":"10.14366/usg.22112","DOIUrl":null,"url":null,"abstract":"Purpose: This study aimed to evaluate the diagnostic value of combined fine-needle aspiration (FNA) with core needle biopsy (CNB) in thyroid nodules.Methods: FNA and CNB were performed simultaneously on 703 nodules. We compared the proportions of inconclusive results and the diagnostic performance for malignancy among FNA, CNB, and combined FNA/CNB for different nodule sizes.Results: Combined FNA/CNB showed lower proportions of inconclusive results than CNB for all nodules (2.8% vs. 5.7%, P<0.001), nodules ≤1.0 cm (4.9% vs. 7.3%, P=0.063), nodules >1.0 cm (2.0% vs. 5.0 %, P<0.001), nodules ≤1.5 cm (3.8% vs. 7.9 %, P<0.001), and nodules >1.5 cm (2.1% vs. 3.9 %, P=0.016). The sensitivity of combined FNA/CNB in predicting malignancy was significantly higher than that of CNB (89.0% vs. 80.0%, P<0.001) and FNA (89.0% vs. 58.1%, P<0.001) for all nodules. Within American College of Radiology Thyroid and Imaging Reporting and Data System grades 4-5, in the subgroup of nodules ≤1.5 cm, combined FNA/ CNB showed the best sensitivity in predicting malignancy (91.4%), significantly higher than that of CNB (81.0%, P<0.001) and FNA (57.8%, P<0.001). However, in the subgroup of nodules >1.5 cm, the difference between combined FNA/CNB and CNB was not significant (84.2% vs. 78.9%, P=0.500).Conclusion: Regardless of nodule size, combined FNA/CNB tended to yield lower proportions of inconclusive results than CNB or FNA alone and exhibited higher performance in diagnosing malignancy. The combined FNA/CNB technique may be a more valuable diagnostic method for nodules ≤1.5 cm and nodules with a risk of malignancy than CNB and FNA alone.","PeriodicalId":54227,"journal":{"name":"Ultrasonography","volume":"42 2","pages":"314-322"},"PeriodicalIF":2.4000,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f3/b7/usg-22112.PMC10071058.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ultrasonography","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.14366/usg.22112","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: This study aimed to evaluate the diagnostic value of combined fine-needle aspiration (FNA) with core needle biopsy (CNB) in thyroid nodules.

Methods: FNA and CNB were performed simultaneously on 703 nodules. We compared the proportions of inconclusive results and the diagnostic performance for malignancy among FNA, CNB, and combined FNA/CNB for different nodule sizes.

Results: Combined FNA/CNB showed lower proportions of inconclusive results than CNB for all nodules (2.8% vs. 5.7%, P<0.001), nodules ≤1.0 cm (4.9% vs. 7.3%, P=0.063), nodules >1.0 cm (2.0% vs. 5.0 %, P<0.001), nodules ≤1.5 cm (3.8% vs. 7.9 %, P<0.001), and nodules >1.5 cm (2.1% vs. 3.9 %, P=0.016). The sensitivity of combined FNA/CNB in predicting malignancy was significantly higher than that of CNB (89.0% vs. 80.0%, P<0.001) and FNA (89.0% vs. 58.1%, P<0.001) for all nodules. Within American College of Radiology Thyroid and Imaging Reporting and Data System grades 4-5, in the subgroup of nodules ≤1.5 cm, combined FNA/ CNB showed the best sensitivity in predicting malignancy (91.4%), significantly higher than that of CNB (81.0%, P<0.001) and FNA (57.8%, P<0.001). However, in the subgroup of nodules >1.5 cm, the difference between combined FNA/CNB and CNB was not significant (84.2% vs. 78.9%, P=0.500).

Conclusion: Regardless of nodule size, combined FNA/CNB tended to yield lower proportions of inconclusive results than CNB or FNA alone and exhibited higher performance in diagnosing malignancy. The combined FNA/CNB technique may be a more valuable diagnostic method for nodules ≤1.5 cm and nodules with a risk of malignancy than CNB and FNA alone.

查看原文本刊更多论文

细针穿刺联合核心针活检评估甲状腺结节:一种更有价值的诊断方法?

目的:探讨细针穿刺(FNA)联合核心针活检(CNB)对甲状腺结节的诊断价值。方法:对703个结节同时行FNA和CNB治疗。我们比较了不同结节大小的FNA、CNB和FNA/CNB联合诊断中不确定结果的比例和恶性肿瘤的诊断性能。结果:FNA/CNB联合治疗对所有结节的不确定结果比例低于CNB(2.8%对5.7%，P1.0 cm(2.0%对5.0%，P1.5 cm(2.1%对3.9%，P=0.016)。FNA/CNB联合预测恶性肿瘤的敏感性显著高于CNB (89.0% vs. 80.0%， P1.5 cm)， FNA/CNB联合与CNB的差异无统计学意义(84.2% vs. 78.9%， P=0.500)。结论:无论结节大小如何，FNA/CNB联合检查的不确定结果比例往往低于CNB或FNA单独检查，在诊断恶性肿瘤方面表现出更高的效能。FNA/CNB联合技术可能是诊断≤1.5 cm及有恶性肿瘤风险的结节比单独CNB和FNA更有价值的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Ultrasonography Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

5.10

自引率

6.50%

发文量

审稿时长

15 weeks

期刊介绍： Ultrasonography, the official English-language journal of the Korean Society of Ultrasound in Medicine (KSUM), is an international peer-reviewed academic journal dedicated to practice, research, technology, and education dealing with medical ultrasound. It is renamed from the Journal of Korean Society of Ultrasound in Medicine in January 2014, and published four times per year: January 1, April 1, July 1, and October 1. Original articles, technical notes, topical reviews, perspectives, pictorial essays, and timely editorial materials are published in Ultrasonography covering state-of-the-art content. Ultrasonography aims to provide updated information on new diagnostic concepts and technical developments, including experimental animal studies using new equipment in addition to well-designed reviews of contemporary issues in patient care. Along with running KSUM Open, the annual international congress of KSUM, Ultrasonography also serves as a medium for cooperation among physicians and specialists from around the world who are focusing on various ultrasound technology and disease problems and relevant basic science.