The role of core needle biopsy in the diagnosis of initially detected thyroid nodules: a systematic review and meta-analysis
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To systematically review the published literature and evaluate the efficacy and safety of core needle biopsy (CNB) for initially detected thyroid nodules.
The Ovid-MEDLINE and Embase databases were searched for studies evaluating CNB for the diagnosis of initially detected thyroid nodules. A meta-analysis was performed to evaluate non-diagnostic results, inconclusive results and diagnostic accuracy for a diagnosis of malignancy with CNB. To overcome heterogeneity, multiple subgroup analyses were performed. The complication rate was also evaluated.
Thirteen eligible studies, which included a total sample size of 9,166 patients with 13,585 nodules, were included. The pooled proportions were 3.5% (95% CI 2.4–5.1) for non-diagnostic results and 13.8% (95% CI 9.1–20.3) for inconclusive results. Considerable heterogeneity was observed among the studies in terms of the pooled proportions for CNB (I2=92.9%, 97%). With regard to the diagnostic performance for malignancy, the sensitivity was 80% (95% CI 75–85) and the specificity was 100% (95% CI 93–100). Only two major complications of CNB were observed.
CNB demonstrates a low non-diagnostic result rate and high diagnostic accuracy for initially detected thyroid nodules and a low major complication rate. These findings indicate that CNB may be a feasible diagnostic tool for patients with initially detected thyroid nodules.
CNB demonstrates high diagnostic accuracy for initially detected thyroid nodules.
CNB demonstrates a low major complication rate.
CNB may be a feasible diagnostic tool for patients with initially detected thyroid nodules.
KeywordsThyroid neoplasms Biopsy, large-core needle Biopsy, fine-needle Ultrasonography
Atypia of undetermined significance
Core needle biopsy
Fine needle aspiration
The authors state that this work has not received any funding.
Compliance with ethical standards
The scientific guarantor of this publication is Jung Hwan Baek.
Conflict of interest
The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.
Statistics and biometry
One of the authors has significant statistical expertise.
Written informed consent was not required for this study because it is systematic review and meta-analysis.
Institutional Review Board approval was not required because it is systematic review and meta-analysis.
- 1.Gharib H, Papini E, Paschke R et al (2010) American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and EuropeanThyroid Association Medical Guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr Pract 16 Suppl 1:1–43CrossRefGoogle Scholar
- 11.Choi YJ, Baek JH, Ha EJ et al (2014) Differences in risk of malignancy and management recommendations in subcategories of thyroid nodules with atypia of undetermined significance or follicular lesion of undetermined significance: the role of ultrasound-guided core-needle biopsy. Thyroid 24:494–501CrossRefGoogle Scholar
- 29.Higgins J, Green S (2011) Cochrane handbook for systematic reviews of interventions version 5.1.0. The Cochrane Collaboration, London. Available via http://handbook.cochrane.org. Accessed 10 Oct 2017
- 56.Gharib H, Papini E, Garber JR et al (2016) American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi Medical Guidelines for clinical practice for the diagnosis and management of thyroid nodules--2016 update. Endocr Pract 22:622–639CrossRefGoogle Scholar
- 58.Haugen BR, Alexander EK, Bible KC et al (2016) 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer. Thyroid 26:1–133CrossRefGoogle Scholar
- 64.Deeks JJ, Bossuyt PM, Gatsonis C (2013) Cochrane handbook for systematic reviews of diagnostic test accuracy version 1.0.0. The Cochrane Collaboration, London. Available via http://srdta.cochrane.org/handbook-dtareviews. Accessed 10 Oct 2017