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Endocrinol Metab : Endocrinology and Metabolism


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Na Kyung Kim  (Kim NK) 1 Article
The Validity of Ultrasonography-Guided Fine Needle Aspiration Biopsy in Thyroid Nodules 4 cm or Larger Depends on Ultrasonography Characteristics
Jin Hwa Kim, Na Kyung Kim, Young Lyun Oh, Hye Jeong Kim, Sang Yong Kim, Jae Hoon Chung, Sun Wook Kim
Endocrinol Metab. 2014;29(4):545-552.   Published online December 29, 2014
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  • 9 Web of Science
  • 9 Crossref
AbstractAbstract PDFPubReader   

The objective of this study was to evaluate the validity of fine needle aspiration biopsy (FNAB) according to ultrasonography (US) characteristics in thyroid nodules 4 cm and larger.


We retrospectively reviewed the cases of 263 patients who underwent thyroid surgery for thyroid nodules larger than 4 cm between January 2001 and December 2010.


The sensitivity of US-FNAB was significantly higher in nodules with calcifications (micro- or macro-) than those without (97.9% vs. 87.% P<0.05). The accuracy of US-FNAB was higher in large thyroid nodules with US features suspicious of malignancy, such as a solid component, ill-defined margin, hypoechogenicity or marked hypoechogenicity, or any calcifications (micro- or macro-) compared to thyroid nodules with none of these features. Furthermore, the accuracy improved as the number of these features increased. The overall false negative rate (FNR) was 11.9%. The FNR of thyroid nodules that appeared benign on US, such as mixed nodules (7.7%) or nodules without calcification (9.8%), trended toward being lower than that of solid nodules (17.9%) or nodules with any microcalcification or macrocalcification (33.3%). In nodules without suspicious features of malignancy, the FNR of US-FNAB was 0% (0/15).


We suggest individualized strategies for large thyroid nodules according to US features. Patients with benign FNAB can be followed in the absence of any malignant features in US. However, if patients exhibit any suspicious features, potential false negative results of FNAB should be kept in mind and surgery may be considered.


Citations to this article as recorded by  
  • Risk of malignancy and diagnostic accuracy of fine-needle aspiration biopsy in thyroid nodules with diameters greater than 4 centimeters
    Rafaela N. Barcelos, Cléber P. Camacho, Maria da Conceição de O. C. Mamone, Elza S. Ikejiri, Felipe A. B. Vanderlei, Ji H. Yang, Rosália P. Padovani, Leandro A. L. Martins, Rosa Paula M. Biscolla, Danielle Macellaro, Susan C. Lindsey, Rui M. B. Maciel, Jo
    Archives of Endocrinology and Metabolism.2023;[Epub]     CrossRef
  • The comparison of accuracy of ultrasonographic features versus ultrasound-guided fine-needle aspiration cytology in diagnosis of malignant thyroid nodules
    Mehrdad Nabahati, Zoleika Moazezi, Soude Fartookzadeh, Rahele Mehraeen, Naser Ghaemian, Majid Sharbatdaran
    Journal of Ultrasound.2019; 22(3): 315.     CrossRef
  • False negative rate of fine‐needle aspiration in thyroid nodules: impact of nodule size and ultrasound pattern
    Hye Shin Ahn, Dong Gyu Na, Jung Hwan Baek, Jin Yong Sung, Ji‐Hoon Kim
    Head & Neck.2019; 41(4): 967.     CrossRef
  • Thyroid nodules over 4 cm do not have higher malignancy or benign cytology false-negative rates
    Muhammed Kizilgul, Rupendra Shrestha, Angela Radulescu, Maria R. Evasovich, Lynn A. Burmeister
    Endocrine.2019; 66(2): 249.     CrossRef
  • Large Cytologically Benign Thyroid Nodules Do Not Have High Rates of Malignancy or False-Negative Rates and Clinical Observation Should be Considered: A Meta-Analysis
    Nicole A. Cipriani, Michael G. White, Peter Angelos, Raymon H. Grogan
    Thyroid.2018; 28(12): 1595.     CrossRef
  • Risk of Malignancy in Thyroid Nodules 4 cm or Larger
    Uchechukwu C. Megwalu
    Endocrinology and Metabolism.2017; 32(1): 77.     CrossRef
  • Usefulness of NRAS codon 61 mutation analysis and core needle biopsy for the diagnosis of thyroid nodules previously diagnosed as atypia of undetermined significance
    Eun Kyung Jang, Won Gu Kim, Eui Young Kim, Hyemi Kwon, Yun Mi Choi, Min Ji Jeon, Jung Hwan Baek, Jeong Hyun Lee, Tae Yong Kim, Young Kee Shong, Jene Choi, Dong Eun Song, Won Bae Kim
    Endocrine.2016; 52(2): 305.     CrossRef
  • Association between neck ultrasonographic findings and clinico‐pathological features in the follicular variant of papillary thyroid carcinoma
    Eun Kyung Jang, Won Gu Kim, Yun Mi Choi, Min Ji Jeon, Hyemi Kwon, Jung Hwan Baek, Jeong Hyun Lee, Tae Yong Kim, Young Kee Shong, Dong Eun Song, Won Bae Kim
    Clinical Endocrinology.2015; 83(6): 968.     CrossRef
  • Articles in 'Endocrinology and Metabolism' in 2014
    Won-Young Lee
    Endocrinology and Metabolism.2015; 30(1): 47.     CrossRef
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