Core needle biopsy can minimise the non-diagnostic results and need for diagnostic surgery in patients with calcified thyroid nodules

Eur Radiol. 2014 Jun;24(6):1403-9. doi: 10.1007/s00330-014-3123-z. Epub 2014 Mar 7.

Abstract

Purpose: To evaluate the role of core needle biopsy (CNB) for calcified thyroid nodules.

Methods: Between October 2008 and July 2011, 264 patients underwent ultrasound-guided CNB for 272 calcified thyroid nodules at our institution. We retrospectively evaluated the incidence of technical failure, non-diagnostic readings, and the diagnostic performance of CNB, and analysed the relationship between the types of calcification and the CNB results. Finally, the incidence of diagnostic surgery was calculated.

Results: The incidence of technical failure was 1.1 % (3/275) and that of non-diagnostic results was 0.7 % (2/272). The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of CNB were 94.7 %, 89.5 %, 100 %, 100 %, and 90.2 %, respectively. There were no significant differences according to the calcification subtype for either the non-diagnostic results or the incidence of technical failure (P > 0.99 and P > 0.99). CNB could prevent diagnostic surgery for 92.9 % (13/14) of the patients who showed more than two non-diagnostic results in previous FNA.

Conclusions: CNB can minimise the non-diagnostic results as well as diagnostic surgery in patients with calcified thyroid nodules. Therefore, CNB may be used as a first-line diagnostic tool for calcified thyroid nodules rather than FNA.

Key points: CNB results show the low incidence of technical failure (1.1 %, 3/275). • CNB results show the low non-diagnostic rate (0.7 %, 2/272). There were no significant differences according to the calcification subtype. CNB can prevent unnecessary diagnostic surgery in 92.9 % (13/14).

MeSH terms

  • Adenoma / diagnostic imaging
  • Adenoma / pathology
  • Adenoma / surgery
  • Adenoma, Oxyphilic
  • Adolescent
  • Adult
  • Aged
  • Biopsy, Fine-Needle / methods
  • Biopsy, Large-Core Needle / methods
  • Calcinosis / diagnostic imaging*
  • Calcinosis / pathology*
  • Calcinosis / surgery
  • Carcinoma / diagnostic imaging
  • Carcinoma / pathology
  • Carcinoma / surgery
  • Carcinoma, Papillary
  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery
  • Female
  • Humans
  • Image-Guided Biopsy / methods
  • Male
  • Middle Aged
  • Retrospective Studies
  • Sensitivity and Specificity
  • Thyroid Cancer, Papillary
  • Thyroid Neoplasms / diagnostic imaging
  • Thyroid Neoplasms / pathology
  • Thyroid Neoplasms / surgery
  • Thyroid Nodule / diagnostic imaging*
  • Thyroid Nodule / pathology*
  • Thyroid Nodule / surgery
  • Ultrasonography, Interventional
  • Young Adult

Supplementary concepts

  • Thyroid cancer, Hurthle cell