Endocrinology and Metabolism

Original Articles

Thyroid
Diagnostic Performance of Thyroid Core Needle Biopsy Using the Revised Reporting System: Comparison with Fine Needle Aspiration Cytology: Kwangsoon Kim, Ja Seong Bae, Jeong Soo Kim, So Lyung Jung, Chan Kwon Jung; Endocrinol Metab. 2022;37(1):159-169. Published online February 28, 2022; DOI: https://doi.org/10.3803/EnM.2021.1299

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Background
We aim to validate the diagnostic performance of thyroid core needle biopsy (CNB) for diagnosing malignancy in clinical settings to align with the changes made in recently updated thyroid CNB guidelines.
Methods
We retrospectively analyzed 1,381 thyroid CNB and 2,223 fine needle aspiration (FNA) samples. The FNA and CNB slides were interpreted according to the Bethesda System for Reporting Thyroid Cytopathology and updated practice guidelines for thyroid CNB, respectively.
Results
Compared to FNA, CNB showed lower rates of inconclusive results: categories I (2.8% vs. 11.2%) and III (1.2% vs. 6.2%), and higher rates of categories II (60.9% vs. 50.4%) and IV (17.5% vs. 2.0%). The upper and lower bounds of the risk of malignancy (ROM) for category IV of CNB were 43.2% and 26.6%, respectively. The CNB subcategory IVb with nuclear atypia had a higher ROM than the subcategory without nuclear atypia (40%–62% vs. 23%–36%). In histologically confirmed cases, there was no significant difference in the diagnostic performance between CNB and FNA for malignancy. However, neoplastic diseases were more frequently detected by CNB than by FNA (88.8% vs. 77.6%, P=0.046). In category IV, there was no difference in unnecessary surgery rate between CNB and FNA (4.7% vs. 6.9%, P=0.6361).
Conclusion
Thyroid CNB decreased the rate of inconclusive results and showed a higher category IV diagnostic rate than FNA. The revised guidelines for thyroid CNB proved to be an excellent reporting system for assessing thyroid nodules.

Citations

Citations to this article as recorded by

Examining the impact of several factors including COVID‐19 on thyroid fine‐needle aspiration biopsy
Muzaffer Serdar Deniz, Merve Dindar
Diagnostic Cytopathology.2024; 52(1): 42. CrossRef
Consensus SFE-AFCE-SFMN 2022 sur la prise en charge des nodules thyroïdiens : intérêt et place de la cytologie thyroïdienne
Myriam Decaussin-Petrucci, Beatrix Cochand Priollet, Emannuelle Leteurtre, Frédérique Albarel, Françoise Borson-Chazot
Annales de Pathologie.2024; 44(1): 20. CrossRef
A comparative analysis of core needle biopsy and repeat fine needle aspiration in patients with inconclusive initial cytology of thyroid nodules
Xuejiao Su, Can Yue, Wanting Yang, Buyun Ma
Frontiers in Endocrinology.2024;[Epub] CrossRef
Preoperative Risk Stratification of Follicular-patterned Thyroid Lesions on Core Needle Biopsy by Histologic Subtyping and RAS Variant-specific Immunohistochemistry
Meejeong Kim, Sora Jeon, Chan Kwon Jung
Endocrine Pathology.2023; 34(2): 247. CrossRef
2023 Korean Thyroid Association Management Guidelines for Patients with Thyroid Nodules
Young Joo Park, Eun Kyung Lee, Young Shin Song, Soo Hwan Kang, Bon Seok Koo, Sun Wook Kim, Dong Gyu Na, Seung-Kuk Baek, So Won Oh, Min Kyoung Lee, Sang-Woo Lee, Young Ah Lee, Yong Sang Lee, Ji Ye Lee, Dong-Jun Lim, Leehi Joo, Yuh-Seog Jung, Chan Kwon Jung
International Journal of Thyroidology.2023; 16(1): 1. CrossRef
Reevaluating diagnostic categories and associated malignancy risks in thyroid core needle biopsy
Chan Kwon Jung
Journal of Pathology and Translational Medicine.2023; 57(4): 208. CrossRef
A Matched-Pair Analysis of Nuclear Morphologic Features Between Core Needle Biopsy and Surgical Specimen in Thyroid Tumors Using a Deep Learning Model
Faridul Haq, Andrey Bychkov, Chan Kwon Jung
Endocrine Pathology.2022; 33(4): 472. CrossRef

Clinical Study
Does Radiofrequency Ablation Induce Neoplastic Changes in Benign Thyroid Nodules: A Preliminary Study: Su Min Ha, Jun Young Shin, Jung Hwan Baek, Dong Eun Song, Sae Rom Chung, Young Jun Choi, Jeong Hyun Lee; Endocrinol Metab. 2019;34(2):169-178. Published online May 15, 2019; DOI: https://doi.org/10.3803/EnM.2019.34.2.169

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Background

To evaluate the clinical feasibility of radiofrequency ablation (RFA) of benign thyroid nodules along with cytomorphological alteration, and any malignant transformation through biopsy.

Methods

The data were retrospectively collected between April 2008 and June 2013 and core needle biopsy (CNB) was performed on 16 benign thyroid nodules previously treated using RFA. The parameters of the patients were compared, between the time of enrollment and the last follow-up examination, using linear mixed model statistical analysis.

Results

No atypical cells or neoplastic transformation were detected in the undertreated peripheral portion of treated benign nodules on the CNB specimen. RFA altered neither the thyroid capsule nor the thyroid tissue adjacent to the treated area. On histopathological examinations, we observed 81.2% acellular hyalinization, which was the most common finding. After a mean follow-up period of over 5 years, the mean volume of thyroid nodule had decreased to 6.4±4.2 mL, with a reduction rate of 81.3%±5.8% (P<0.0001).

Conclusion

RFA is a technically feasible treatment method for benign thyroid nodules, with no carcinogenic effect or tissue damage of the normal thyroid tissue adjacent to the RFA-treated zone.

Citations

Citations to this article as recorded by

Comparison of the Therapeutic Efficacy and Technical Outcomes between Conventional Fixed Electrodes and Adjustable Electrodes in the Radiofrequency Ablation of Benign Thyroid Nodules
Jae Ho Shin, Minkook Seo, Min Kyoung Lee, So Lyung Jung
Korean Journal of Radiology.2024; 25(2): 199. CrossRef
Thermoablation of thyroid nodules reveals excellent results with low morbidity
Robert M. Eisele, Philipp R. Scherber, Monika Schlüter, Thorsten Drews, Matthias Glanemann, Gereon Gäbelein
Technology and Health Care.2022; 30(3): 683. CrossRef
Radiofrequency ablation and related ultrasound‐guided ablation technologies for treatment of benign and malignant thyroid disease: An international multidisciplinary consensus statement of the American Head and Neck Society Endocrine Surgery Section with
Lisa A. Orloff, Julia E. Noel, Brendan C. Stack, Marika D. Russell, Peter Angelos, Jung Hwan Baek, Kevin T. Brumund, Feng‐Yu Chiang, Mary Beth Cunnane, Louise Davies, Andrea Frasoldati, Anne Y. Feng, Laszlo Hegedüs, Ayaka J. Iwata, Emad Kandil, Jennifer K
Head & Neck.2022; 44(3): 633. CrossRef
Thyroid Nodule Radiofrequency Ablation: Complications and Clinical Follow Up
James Y. Lim, Jennifer H. Kuo
Techniques in Vascular and Interventional Radiology.2022; 25(2): 100824. CrossRef
American Association of Clinical Endocrinology Disease State Clinical Review: The Clinical Utility of Minimally Invasive Interventional Procedures in the Management of Benign and Malignant Thyroid Lesions
Sina Jasim, Kepal N. Patel, Gregory Randolph, Stephanie Adams, Roberto Cesareo, Edward Condon, Tara Henrichsen, Malak Itani, Maria Papaleontiou, Leonardo Rangel, John Schmitz, Marius N. Stan
Endocrine Practice.2022; 28(4): 433. CrossRef
Efficacy of radiofrequency and laser thermal ablation in solving thyroid nodule-related symptoms and cosmetic concerns. A systematic review and meta-analysis
Roberto Cesareo, Silvia Egiddi, Anda M. Naciu, Gaia Tabacco, Andrea Leoncini, Nicola Napoli, Andrea Palermo, Pierpaolo Trimboli
Reviews in Endocrine and Metabolic Disorders.2022; 23(5): 1051. CrossRef
Comparison of ultrasound-guided radiofrequency ablation versus thyroid lobectomy for T1bN0M0 papillary thyroid carcinoma
Lin Yan, Xinyang Li, Yingying Li, Jing Xiao, Mingbo Zhang, Yukun Luo
European Radiology.2022; 33(1): 730. CrossRef
A systematic review and meta-analysis comparing tumor progression and complications between radiofrequency ablation and thyroidectomy for papillary thyroid carcinoma
Yuan-dong Sun, Hao Zhang, Hai-tao Zhu, Chun-xue Wu, Miao-ling Chen, Jian-jun Han
Frontiers in Oncology.2022;[Epub] CrossRef
RFA and benign thyroid nodules: Review of the current literature
Haris Muhammad, Prasanna Santhanam, Jonathon O. Russell, Jennifer H. Kuo
Laryngoscope Investigative Otolaryngology.2021; 6(1): 155. CrossRef
Radiofrequency ablation and thyroid nodules: updated systematic review
Haris Muhammad, Prasanna Santhanam, Jonathon O. Russell
Endocrine.2021; 72(3): 619. CrossRef
Complications of RFA for Thyroid Nodules: Prevention and Management
Rahul K. Sharma, Jennifer H Kuo
Current Otorhinolaryngology Reports.2021; 9(1): 79. CrossRef
Long-Term Results of Ultrasound-Guided Radiofrequency Ablation of Benign Thyroid Nodules: State of the Art and Future Perspectives—A Systematic Review
Hervé Monpeyssen, Ahmad Alamri, Adrien Ben Hamou
Frontiers in Endocrinology.2021;[Epub] CrossRef
Long-Term Outcomes of Thermal Ablation for Benign Thyroid Nodules: The Issue of Regrowth
Jung Suk Sim, Jung Hwan Baek, Rosaria Meccariello
International Journal of Endocrinology.2021; 2021: 1. CrossRef
Ultrasound-Guided Radiofrequency Ablation Versus Thyroid Lobectomy for Low-Risk Papillary Thyroid Microcarcinoma: A Propensity-Matched Cohort Study of 884 Patients
Lin Yan, Mingbo Zhang, Qing Song, Yukun Luo
Thyroid.2021; 31(11): 1662. CrossRef
Clinical Effects of Microwave Ablation in the Treatment of Low-Risk Papillary Thyroid Microcarcinomas and Related Histopathological Changes
Chenya Lu, Xingjia Li, Xiaoqiu Chu, Ruiping Li, Jie Li, Jianhua Wang, Yalin Wang, Yang Xu, Guofang Chen, Shuhang Xu, Chao Liu
Frontiers in Endocrinology.2021;[Epub] CrossRef
Ultrasound-Guided Thermal Ablation of Thyroid Nodules: Technicalities Progress and Clinical Applications, Especially in Malignant Thyroid Nodules
Enock Adjei Agyekum, Jian-hua Fu, Fei-Ju Xu, Yong-Zhen Ren, Debora Akortia, Qing Chen, Xiao-Qin Qian, Yuguo Wang, Xian Wang
Frontiers in Oncology.2021;[Epub] CrossRef
Comparison Between Radiofrequency Ablation and Microwave Ablation in the Treatment for Benign Thyroid Nodules: a Meta-analysis
Jing Wu, Junguo Liu, Li Liu
Indian Journal of Surgery.2021;[Epub] CrossRef
2020 European Thyroid Association Clinical Practice Guideline for the Use of Image-Guided Ablation in Benign Thyroid Nodules
Enrico Papini, Hervé Monpeyssen, Andrea Frasoldati, Laszlo Hegedüs
European Thyroid Journal.2020; 9(4): 172. CrossRef
Response: Long-Term Outcomes Following Thermal Ablation of Benign Thyroid Nodules as an Alternative to Surgery: The Importance of Controlling Regrowth (Endocrinol Metab 2019;34:117–23, Jung Suk Sim et al.)
Jung Suk Sim, Jung Hwan Baek
Endocrinology and Metabolism.2019; 34(3): 325. CrossRef

Thyroid
A Comparison of Ultrasound-Guided Fine Needle Aspiration versus Core Needle Biopsy for Thyroid Nodules: Pain, Tolerability, and Complications: Eun Ji Jeong, Sae Rom Chung, Jung Hwan Baek, Young Jun Choi, Jae Kyun Kim, Jeong Hyun Lee; Endocrinol Metab. 2018;33(1):114-120. Published online March 21, 2018; DOI: https://doi.org/10.3803/EnM.2018.33.1.114

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61 Download
24 Web of Science
22 Crossref

Abstract PDF PubReader ePub

Background

To compare pain, tolerability, and complications associated with fine needle aspiration (FNA) versus core needle biopsy (CNB).

Methods

FNAs were performed using 23-gauge needles and CNBs were performed using 18-gauge double-action spring-activated needles in 100 patients for each procedure. Patients were asked to record a pain score using a 10-cm visual analog scale and procedure tolerability. Complications and number of biopsies were recorded.

Results

The median pain scores were similar for the FNA and CNB approaches during and 20 minutes after the biopsy procedures (3.7 vs. 3.6, P=0.454; 0.9 vs. 1.1, P=0.296, respectively). The procedure was tolerable in all 100 FNA patients and in 97 CNB patients (P=0.246). The mean number of biopsies was fewer in the CNB group (1.4 vs. 1.2, P=0.002). By subgroup analysis (staff vs. non-staff), no significant difference was detected in any parameter. There were no major complications in either group, but three patients who underwent CNB had minor complications (P=0.246).

Conclusion

FNA and CNB show no significant differences for diagnosing thyroid nodules in terms of pain, tolerability, or complications.

Citations

Citations to this article as recorded by

A comparative analysis of core needle biopsy and repeat fine needle aspiration in patients with inconclusive initial cytology of thyroid nodules
Xuejiao Su, Can Yue, Wanting Yang, Buyun Ma
Frontiers in Endocrinology.2024;[Epub] CrossRef
Assessing Adequacy: A Meta-Analysis of Rapid Onsite Evaluation of Thyroid Nodules
Peter P. Issa, Christina McCarthy, Mohammad Hussein, Aaron L. Albuck, Essam Emad, Mohamed Shama, Krzysztof Moroz, Eman Toraih, Emad Kandil
Journal of Surgical Research.2024; 296: 523. CrossRef
Histology-based and cytology-based needle sampling for targeted next-generation sequencing in the indeterminate thyroid tumors
Chun-Nan Chen, Tsung-Lin Yang
European Archives of Oto-Rhino-Laryngology.2023; 280(8): 3773. CrossRef
Preoperative evaluation of thyroid nodules – Diagnosis and management strategies
Tapoi Dana Antonia, Lambrescu Ioana Maria, Gheorghisan-Galateanu Ancuta-Augustina
Pathology - Research and Practice.2023; 246: 154516. CrossRef
Keloid Development After Fine Needle Aspiration of the Thyroid: A Rare Case and Review of Management Strategies
Shaniah S Holder, Alaerebo S Malvan-iyalla, Sara Arfan, Vimal Basani, Frederick Tiesenga
Cureus.2023;[Epub] CrossRef
Utilidad de la biopsia con aguja gruesa ecoguiada en nódulos tiroideos con punción aspirativa con aguja fina no diagnóstica
R. Cortázar-García, M.D. Martín-Escalante, L. Robles-Cabeza, C. Martínez-Santos
Radiología.2022; 64(3): 195. CrossRef
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Sona J Appukutty, Anna Paterson, Nishant S Patel, Adam Duckworth, James Chan, Maria O'Donovan, Alison J Marker
Journal of Clinical Pathology.2022; 75(9): 620. CrossRef
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Ta-Hsuan Lo, Cheng-Ping Wang, Chun-Nan Chen, Tsung-Lin Yang, Pei-Jen Lou, Jenq-Yuh Ko, Yih-Leong Chang, Tseng-Cheng Chen
Scientific Reports.2022;[Epub] CrossRef
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Chun-Nan Chen, Min-Shu Hsieh, Yi-Hsuan Lee, Tsung-Lin Yang
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Tao Liu, Manisha Tilak, Sara Awad, Joshua Lakoff
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Usefulness of ultrasound-guided core biopsy in thyroid nodules with inconclusive fine-needle aspiration biopsy findings
R. Cortázar-García, M.D. Martín-Escalante, L. Robles-Cabeza, C. Martínez-Santos
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Permanent vocal fold paralysis after ultrasound-guided core needle biopsy of thyroid nodule
Kathrin Zimmerman, Matthew Hoffman, Amalee Smith, C. Blake Simpson
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Interobserver variability in ultrasound assessment of thyroid nodules
Jaber Alyami, Fahad F. Almutairi, Sultan Aldoassary, Amani Albeshry, Ali Almontashri, Mazen Abounassif, Majed Alamri
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Soon-Hyun Ahn
Clinical and Experimental Otorhinolaryngology.2021; 14(1): 116. CrossRef
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