Comparison of Diagnostic Accuracy of Thyroid Cancer With Ultrasound-Guided Fine-Needle Aspiration and Core-Needle Biopsy: A Systematic Review and Meta-Analysis

Overview

Journal Front Endocrinol (Lausanne)

Specialty Endocrinology

Date 2020 Mar 3

PMID 32117069

Citations 14

Authors

Ling Lan

Yong Luo

Meicen Zhou

Lili Huo

Hailing Chen

Qingyao Zuo

Wei Deng

Affiliations

Soon will be listed here.

Abstract

This systematic review and meta-analysis aimed to evaluate the accuracy of fine-needle aspiration (FNA) and core-needle biopsy (CNB) in diagnosing thyroid cancer. The PubMed, Embase, and Cochrane Library databases were retrieved up to May 2019, and the overall accuracy of FNA and CNB in diagnosing thyroid cancer was evaluated by meta-analysis. The sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR) were calculated. The summary receiver operating characteristic (ROC) curve was estimated, and the area under the ROC curve (AUC) was calculated. Ten eligible studies, involving 10,078 patients with 10,842 thyroid nodules, were included. The overall sensitivity and specificity of FNA and CNB for thyroid cancer were 0.72 [95 % confidence interval (CI): 0.69-0.74], 0.99 (95% CI: 0.98-0.99), and 0.83 (95% CI: 0.81-0.85), 0.99 (95% CI: 0.98-0.99), respectively. Other parameters used to assess efficacy included PLR 41.71 (2.15-808.27) and 51.56 (3.20-841.47), NLR 0.31 (0.22-0.42) and 0.22 (0.15-0.32), for FNA and CNB, respectively. Overall, the pooled summary ROC (AUC) value of FNA and CNB was 0.9025 and 0.7926, respectively. No significant difference was observed between the two AUCs of FNA and CNB ( = 0.164). FNA and CNB are still similar as first-line diagnostic tools. FNA remains a good first-line method for detecting thyroid malignancies.

Citing Articles

Integrated intraoperative predictive model for malignancy risk assessment of thyroid nodules with atypia of undetermined significance cytology.

Li C, Luo Y, Jiang Y, Li Q Sci Rep. 2025; 15(1):1860.

PMID: 39805960 PMC: 11730291. DOI: 10.1038/s41598-024-84716-2.

Core needle biopsy: an efficacious adjunct to cytological diagnosis in thyroid tumours suspected of anaplastic carcinoma - single-centre experience.

Bakula-Zalewska E, Kwapisz M, Goralski P, Dlugosinska J, Galczynski J, Dedecjus M Contemp Oncol (Pozn). 2024; 28(2):167-171.

PMID: 39421712 PMC: 11480912. DOI: 10.5114/wo.2024.142468.

Role of ultrasound‑guided fine‑needle aspiration cytology combined with thyroid peroxidase and thyroglobulin antibodies in evaluating cervical lymph node metastasis in thyroid cancer.

Weng L Oncol Lett. 2024; 28(5):512.

PMID: 39268165 PMC: 11391521. DOI: 10.3892/ol.2024.14645.

Minimally invasive biopsy-based diagnostics in support of precision cancer medicine.

Franzen B, Auer G, Lewensohn R Mol Oncol. 2024; 18(11):2612-2628.

PMID: 38519839 PMC: 11547246. DOI: 10.1002/1878-0261.13640.

A comparative analysis of core needle biopsy and repeat fine needle aspiration in patients with inconclusive initial cytology of thyroid nodules.

Su X, Yue C, Yang W, Ma B Front Endocrinol (Lausanne). 2024; 15:1309005.

PMID: 38356956 PMC: 10865505. DOI: 10.3389/fendo.2024.1309005.

References

Choi Y, Baek J, Suh C, Shim W, Jeong B, Kim J . Core-needle biopsy versus repeat fine-needle aspiration for thyroid nodules initially read as atypia/follicular lesion of undetermined significance. Head Neck. 2016; 39(2):361-369. DOI: 10.1002/hed.24597. View

Renshaw A, Pinnar N . Comparison of thyroid fine-needle aspiration and core needle biopsy. Am J Clin Pathol. 2007; 128(3):370-4. DOI: 10.1309/07TL3V58337TXHMC. View

Ahn S, Park S, Choi S . Comparison of Consecutive Results from Fine Needle Aspiration and Core Needle Biopsy in Thyroid Nodules. Endocr Pathol. 2017; 28(4):332-338. DOI: 10.1007/s12022-017-9496-1. View

Whiting P, Rutjes A, Westwood M, Mallett S, Deeks J, Reitsma J . QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011; 155(8):529-36. DOI: 10.7326/0003-4819-155-8-201110180-00009. View

Hong M, Na D, Kim S, Kim D . Role of core needle biopsy as a first-line diagnostic tool for thyroid nodules: a retrospective cohort study. Ultrasonography. 2017; 37(3):244-253. PMC: 6044216. DOI: 10.14366/usg.17041. View

Cibas E, Ali S . The Bethesda System for Reporting Thyroid Cytopathology. Thyroid. 2009; 19(11):1159-65. DOI: 10.1089/thy.2009.0274. View

Suh C, Baek J, Lee J, Choi Y, Kim J, Sung T . The Role of Core-Needle Biopsy as a First-Line Diagnostic Tool for Initially Detected Thyroid Nodules. Thyroid. 2015; 26(3):395-403. DOI: 10.1089/thy.2015.0404. View

Siegel R, Miller K, Jemal A . Cancer statistics, 2016. CA Cancer J Clin. 2016; 66(1):7-30. DOI: 10.3322/caac.21332. View

Nasrollah N, Trimboli P, Rossi F, Amendola S, Guidobaldi L, Ventura C . Patient's comfort with and tolerability of thyroid core needle biopsy. Endocrine. 2013; 45(1):79-83. DOI: 10.1007/s12020-013-9979-x. View

10.

Suh C, Baek J, Choi Y, Kim T, Sung T, Song D . Efficacy and safety of core-needle biopsy in initially detected thyroid nodules via propensity score analysis. Sci Rep. 2017; 7(1):8242. PMC: 5557918. DOI: 10.1038/s41598-017-07924-z. View

11.

Novoa E, Gurtler N, Arnoux A, Kraft M . Role of ultrasound-guided core-needle biopsy in the assessment of head and neck lesions: a meta-analysis and systematic review of the literature. Head Neck. 2011; 34(10):1497-503. DOI: 10.1002/hed.21821. View

12.

Suh C, Baek J, Lee J, Choi Y, Kim K, Lee J . The role of core-needle biopsy in the diagnosis of thyroid malignancy in 4580 patients with 4746 thyroid nodules: a systematic review and meta-analysis. Endocrine. 2016; 54(2):315-328. DOI: 10.1007/s12020-016-0991-9. View

13.

Choi Y, Baek J, Ha E, Lim H, Lee J, Kim J . Differences in risk of malignancy and management recommendations in subcategories of thyroid nodules with atypia of undetermined significance or follicular lesion of undetermined significance: the role of ultrasound-guided core-needle biopsy. Thyroid. 2013; 24(3):494-501. DOI: 10.1089/thy.2012.0635. View

14.

Hakala T, Kholova I, Sand J, Saaristo R, Kellokumpu-Lehtinen P . A core needle biopsy provides more malignancy-specific results than fine-needle aspiration biopsy in thyroid nodules suspicious for malignancy. J Clin Pathol. 2013; 66(12):1046-50. DOI: 10.1136/jclinpath-2013-201559. View

15.

Yang J, Schnadig V, Logrono R, Wasserman P . Fine-needle aspiration of thyroid nodules: a study of 4703 patients with histologic and clinical correlations. Cancer. 2007; 111(5):306-15. DOI: 10.1002/cncr.22955. View

16.

Choi S, Baek J, Lee J, Choi Y, Hong M, Song D . Thyroid nodules with initially non-diagnostic, fine-needle aspiration results: comparison of core-needle biopsy and repeated fine-needle aspiration. Eur Radiol. 2014; 24(11):2819-26. DOI: 10.1007/s00330-014-3325-4. View

17.

Na D, Kim J, Sung J, Baek J, Jung K, Lee H . Core-needle biopsy is more useful than repeat fine-needle aspiration in thyroid nodules read as nondiagnostic or atypia of undetermined significance by the Bethesda system for reporting thyroid cytopathology. Thyroid. 2012; 22(5):468-75. DOI: 10.1089/thy.2011.0185. View

18.

Moher D, Liberati A, Tetzlaff J, Altman D . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009; 151(4):264-9, W64. DOI: 10.7326/0003-4819-151-4-200908180-00135. View

19.

Karstrup S, Balslev E, Juul N, Eskildsen P, Baumbach L . US-guided fine needle aspiration versus coarse needle biopsy of thyroid nodules. Eur J Ultrasound. 2001; 13(1):1-5. DOI: 10.1016/s0929-8266(01)00116-1. View

20.

Trimboli P, Fulciniti F, Zilioli V, Ceriani L, Giovanella L . Accuracy of international ultrasound risk stratification systems in thyroid lesions cytologically classified as indeterminate. Diagn Cytopathol. 2016; 45(2):113-117. DOI: 10.1002/dc.23651. View