Comparison of diagnostic yield of core-needle and fine-needle aspiration biopsies of thyroid lesions: Systematic review and meta-analysis

Kosma Wolinski,Marek Ruchala,Adam Stangierski

doi:10.1007/s00330-016-4356-9

Kosma Wolinski, Marek Ruchala + Show 1 more

Open Access

https://doi.org/10.1007/s00330-016-4356-9

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Journal: European radiology	Publication Date: Apr 18, 2016
Citations: 35	License type: open-access

Affiliation: Poznan University of Medical Sciences

Abstract

ObjectivesThyroid nodular disease is one of the most commonly observed medical conditions. Cytological evaluation of the specimens obtained with fine-needle aspiration biopsy (FNAB) is the most accurate tool for selecting nodules which should be further surgically removed. A major limitation of this method is the high occurrence of non-diagnostic results. This indicates the need for improvement of the thyroid biopsy technique. The aim of this meta-analysis was to compare the diagnostic value of thyroid core-needle biopsies (CNBs) and FNABs.Materials and methodsPubMed/MEDLINE, Cochrane Library, Scopus, Cinahl, Academic Search Complete, Web of Knowledge, PubMed Central, PubMed Central Canada and Clinical Key databases were searched. Risk ratios (RRs) of non-diagnostic results were meta-analysed using the random-effects model.ResultsEleven studies were included in the quantitative analysis. CNB yielded significantly more diagnostic results – the pooled risk ratio (RR) of gaining a non-diagnostic result was 0.27 (p<0.0001). For lesions with one previous non-diagnostic FNAB, RR was 0.22 (p<0.0001).ConclusionsCNB seems to be a valuable diagnostic technique yielding a higher proportion of diagnostic results than conventional FNAB. It is also significantly more effective in case of nodules with a prior non-diagnostic result of FNAB results than repeated FNABs.Key Points• Core-needle biopsy yields a higher proportion of diagnostic results than fine-needle biopsy.• Core-needle biopsies may decrease the amount of unnecessary thyroidectomies.• Probability of gaining non-diagnostic result using core-needle biopsy is almost four times lower.

Highlights

Thyroid nodular disease (TND) is one of the most commonly observed medical conditions, affecting a large number of individuals, especially women, subpopulations in iodinedeficient regions, elderly people and patients with some specific clinical conditions
Cytological evaluation of the specimens obtained with fine-needle aspiration biopsy (FNAB) is the most accurate tool for selecting nodules which should be further surgically removed [6]
Articles comparing the percentage of diagnostic results of thyroid FNAB and core-needle biopsies (CNBs), performed with sonographic guidance, were included in the meta-analysis

Summary

Introduction

Thyroid nodular disease (TND) is one of the most commonly observed medical conditions, affecting a large number of individuals, especially women, subpopulations in iodinedeficient regions, elderly people and patients with some specific clinical conditions. The prevalence of TND is high, affecting 10–70 % of the general population and malignancies are observed in 3–10 % of patients [1,2,3,4,5]. Most endocrinological societies recommend consideration of total thyroidectomy in cases of repeated FNABs with non-diagnostic results [11]. This may increase the number of unnecessary thyroidectomies and delay the final diagnosis of thyroid cancer.

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