title: Role of core needle biopsy and ultrasonographic finding in management of indeterminate thyroid nodules.
abstract: BACKGROUND
  Thyroid fine-needle aspiration (FNA) is used as a screening test of choice for evaluation of thyroid nodules. However, approximately 15% to 25% of the cases are classified as indeterminate, posing dilemmas in decision-making. This study was designed to compare the diagnostic performances of second FNA and core needle biopsy of indeterminate nodules by initial FNA.
  
  
  METHODS
  From February 2005 through June 2009, 258 patients who completed scheduled follow-ups were enrolled and the follow-up results were analyzed.
  
  
  RESULTS
  Nondiagnostic results were obtained in 41.8% of the second FNA group and in 1.7% of the core needle biopsy group (p < .001; chi-square). The nodules that show borderline features in preoperative ultrasonography had a malignancy rate of 18.3% and could be identified successfully with core needle biopsy.
  
  
  CONCLUSIONS
  Core needle biopsy is a better method for evaluating indeterminate nodules by initial FNA than second FNA, especially in patients with ultrasonographic findings of a borderline nodule.
authors.affiliation: Department of Otorhinolaryngology, Seoul National University College of Medicine, Bundang Hospital, Gyeonggi-Do, Seoul, Korea.
authors.forename: Kyung Tae
authors.initials: KT
authors.lastname: Park
authors.forename: Soon-Hyun
authors.initials: SH
authors.lastname: Ahn
authors.forename: Ji-Hun
authors.initials: JH
authors.lastname: Mo
authors.forename: Young Joo
authors.initials: YJ
authors.lastname: Park
authors.forename: Do Joong
authors.initials: DJ
authors.lastname: Park
authors.forename: Sang Il
authors.initials: SI
authors.lastname: Choi
authors.forename: So-Yeon
authors.initials: SY
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D001707:Biopsy, Needle / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome; D014463:Ultrasonography