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      Core Needle Biopsy of the Thyroid: 2016 Consensus Statement and Recommendations from Korean Society of Thyroid Radiology

      review-article
      Author(s): , MD, PhD 1 , , MD, PhD 2 , , , MD, PhD 3 , , MD, PhD 4 , , MD 5 , , MD 5 , 17 , , MD, PhD 2 , , MD, PhD 6 , , MD 7 , , MD, PhD 8 , , MD 9 , , MD 1 , 18 , , MD 6 , , MD 10 , , MD 2 , , MD 7 , , MD 11 , , MD 12 , , MD 10 , , MD 13 , , MD, PhD 14 , , MD, PhD 15 , , MD, PhD 16 , Korean Society of Thyroid Radiology (KSThR) and Korean Society of Radiology
      Publication date (Electronic):
      Journal: Korean Journal of Radiology
      Publisher: The Korean Society of Radiology
      Keywords: Thyroid, Thyroid nodule, Thyroid neoplasms, FNA, CNB

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          Abstract

          Core needle biopsy (CNB) has been suggested as a complementary diagnostic method to fine-needle aspiration in patients with thyroid nodules. Many recent CNB studies have suggested a more advanced role for CNB, but there are still no guidelines on its use. Therefore, the Task Force Committee of the Korean Society of Thyroid Radiology has developed the present consensus statement and recommendations for the role of CNB in the diagnosis of thyroid nodules. These recommendations are based on evidence from the current literature and expert consensus.

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          Long-term assessment of a multidisciplinary approach to thyroid nodule diagnostic evaluation.

          Kathleen A. Alexander, Alexander Benson, Robert Moore … (2007)
          The diagnostic evaluation of patients with thyroid nodules is imprecise. Despite the benefits of fine-needle aspiration (FNA), most patients who are referred for surgery because of abnormal cytology prove to have benign disease. Recent technologic and procedural advances suggest that this shortcoming can be mitigated, although few data confirm this benefit in unselected patients. A total of 2587 sequential patients were evaluated by thyroid ultrasound and were offered ultrasound-guided FNA (UG-FNA) of all thyroid nodules that measured > or =1 cm during a 10-year period. Results of aspiration cytology were correlated with histologic findings. The prevalence of thyroid cancer in all patients and in those who underwent surgery was determined. Surgical risk was calculated. Tumors that measured > or =1 cm were present in 14% of patients: Forty-three percent of patients had tumors that measured <2 cm in greatest dimension, and 93% had American Joint Committee on Cancer stage I or II disease. The cytologic diagnoses 'positive for malignancy' and 'no malignant cells' were 97% predictive and 99.7% predictive, respectively. Repeat FNA of initial insufficient aspirates, as well as more detailed classification of inconclusive aspirates, improved preoperative assessment of cancer risk and reduced surgical intervention. Fifty-six percent of patients who were referred for surgery because of abnormal cytology had cancer compared with from 10% to 45% of patients historically. An analysis of operative complications from a subset of 296 patients demonstrated a 1% risk of permanent surgical complications. The current findings demonstrated the benefits of UG-FNA and of a more detailed classification of inconclusive aspirates in the preoperative risk assessment of thyroid nodules, supporting adherence to recently published guidelines. 2007 American Cancer Society
          Article 0 comments Cited 137 times – based on 0 reviews     Review now
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            Fine-needle aspiration of thyroid nodules: a study of 4703 patients with histologic and clinical correlations.

            Roberto Logroño, Patricia Wasserman, Jack Yang … (2007)
            The Papanicolaou Society of Cytopathology recently proposed 6 diagnostic categories for the classification of thyroid fine-needle aspiration (FNA) cytology. Using these categories, the experience with FNA from 2 institutions was studied with emphasis on cytologic-histologic correlation, source of errors, and clinical management. Patient cytology data were retrieved by a retrospective search of thyroid FNA in the institutional databases. Cytologic diagnoses were classified as unsatisfactory, benign, atypical cellular lesion (ACL), follicular neoplasm (FN), suspicious for malignancy, and positive for malignancy. Samples with a histologic discrepancy were re-evaluated, and clinical follow-up information was recorded. Of 4703 FNA samples, 10.4% were classified as unsatisfactory, 64.6% were classified as benign, 3.2% were classified as ACL, 11.6% were classified as FN, 2.6% were classified as suspicious, and 7.6% were classified as malignant. Five hundred twelve patients had at least 1 repeat FNA, mainly for results in the unsatisfactory and ACL categories. One thousand fifty-two patients had surgical follow-up, including 14.9% of patients with unsatisfactory FNA results, 9.8% of patients with benign results, 40.6% of patients with ACL results, 63.1% of patients with FN results, 86.1% of patients with suspicious results, and 79.3% of patients with malignant results. The rates for histologically confirmed malignancy in these categories were 10.9%, 7.3%, 13.5%, 32.2%, 64.7%, and 98.6%, respectively. The cytologic-histologic diagnostic discrepancy rate was 15.3%. Sources of errors included diagnoses on inadequate specimens, sample errors, and overlapping cytologic features between hyperplastic nodules and follicular adenoma. The sensitivity and specificity of thyroid FNA for the diagnosis of malignancy were 94% and 98.5%, respectively. The current results indicated that FNA provides an accurate diagnosis of thyroid malignancy. The 6 diagnostic categories were beneficial for triaging patients for either clinical follow-up or surgical management.
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              Complications encountered in the treatment of benign thyroid nodules with US-guided radiofrequency ablation: a multicenter study.

              So-Lyung Jung, D. Kim, Sun I l Kim … (2011)
              To evaluate clinical aspects and imaging features of complications encountered in the treatment of benign thyroid nodules with radiofrequency (RF) ablation. Institutional review board approval was obtained for this retrospective study, and informed consent was waived. From June 2002 to September 2009, 1459 patients underwent RF ablation of 1543 thyroid nodules with an RF system with internally cooled electrodes at 13 thyroid centers, which were members of Korean Society of Thyroid Radiology. Numbers and types of major and minor complications were assessed. The authors observed 48 complications (3.3%), 20 major and 28 minor. The major complications were voice changes (n = 15), brachial plexus injury (n = 1), tumor rupture (n = 3), and permanent hypothyroidism (n = 1). The minor complications were hematoma (n = 15), skin burn (n = 4), and vomiting (n = 9). All patients recovered spontaneously except for one with permanent hypothyroidism and one who underwent surgery. Although the complication rate of RF ablation is low, various complications may occur; comprehension of complications and suggested technical tips may prevent complications or properly manage those that occur. © RSNA, 2011.
              Article 0 comments Cited 107 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Korean J Radiol
                Journal ID (iso-abbrev): Korean J Radiol
                Journal ID (publisher-id): KJR
                Title: Korean Journal of Radiology
                Publisher: The Korean Society of Radiology
                ISSN (Print): 1229-6929
                ISSN (Electronic): 2005-8330
                Publication date (Print): Jan-Feb 2017
                Publication date (Electronic): 05 January 2017
                Volume: 18
                Issue: 1
                Pages: 217-237
                Affiliations
                [1 ]Department of Radiology, Human Medical Imaging and Intervention Center, Seoul 06524, Korea.
                [2 ]Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea.
                [3 ]Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
                [4 ]Department of Radiology, Seoul National University College of Medicine, Seoul 03080, Korea.
                [5 ]Department of Radiology and Thyroid Center, Daerim St. Mary's Hospital, Seoul 07442, Korea.
                [6 ]Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
                [7 ]Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University, Seoul 03181, Korea.
                [8 ]Department of Radiology, Ajou University School of Medicine, Suwon 16499, Korea.
                [9 ]Department of Radiology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul 04401, Korea.
                [10 ]Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan 48108, Korea.
                [11 ]Department of Radiology, Konyang University Hospital, Konyang University College of Medicine, Daejeon 35365, Korea.
                [12 ]Department of Radiology and Thyroid Center, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul 06973, Korea.
                [13 ]Department of Radiology, Sharing and Happiness Hospital, Busan 48101, Korea.
                [14 ]Department of Radiology, Withsim Clinic, Seongnam 13590, Korea.
                [15 ]Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
                [16 ]Department of Radiology, Dong-A University Medical Center, Busan 49201, Korea.
                [17 ]Department of Radiology, Smarton Hospital, Bucheon 14534, Korea.
                [18 ]Department of Radiology, New Korea Hospital, Kimpo 10086, Korea.
                Author notes
                Corresponding author: Jung Hwan Baek, MD, PhD, Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro, 43-gil, Songpa-gu, Seoul 05505, Korea. Tel: (822) 3010-4352, Fax: (822) 476-0090, radbaek@ 123456naver.com
                Article
                DOI: 10.3348/kjr.2017.18.1.217
                PMC ID: 5240493
                PubMed ID: 28096731
                SO-VID: 2445d7bf-862a-43d4-b87e-798555ecd025
                Copyright © Copyright © 2017 The Korean Society of Radiology
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 25 August 2016
                Date accepted : 12 September 2016
                Categories
                Subject: Thyroid
                Subject: Review Article

                ScienceOpen disciplines: Radiology & Imaging
                Keywords: thyroid,thyroid nodule,thyroid neoplasms,fna,cnb
                Data availability:
                ScienceOpen disciplines: Radiology & Imaging
                Keywords: thyroid, thyroid nodule, thyroid neoplasms, fna, cnb

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