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

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).