title: Diagnosis of thyroid follicular neoplasm: fine-needle aspiration versus core-needle biopsy.
abstract: BACKGROUND
  Although fine-needle aspiration (FNA) is a safe and accurate diagnostic procedure for assessing thyroid nodules, it has limitations in diagnosing follicular neoplasms due to its relatively high false-positive rate. The purpose of the present study was to evaluate the diagnostic role of core-needle biopsy (CNB) for thyroid nodules with follicular neoplasm (FN) in comparison with FNA.
  
  
  METHODS
  A series of 107 patients (24 men, 83 women; mean age, 47.4 years) from 231 FNAs and 107 patients (29 men, 78 women; mean age, 46.3 years) from 186 CNBs with FN readings, all of whom underwent surgery, from October 2008 to December 2013 were retrospectively analyzed. The false-positive rate, unnecessary surgery rate, and malignancy rate for the FNA and CNB patients according to the final diagnosis following surgery were evaluated.
  
  
  RESULTS
  The CNB showed a significantly lower false-positive and unnecessary surgery rate than the FNA (4.7% versus 30.8%, 3.7% versus 26.2%, p < 0.001, respectively). In the FNA group, 33 patients (30.8%) had non-neoplasms, including nodular hyperplasia (n = 32) and chronic lymphocytic thyroiditis (n = 1). In the CNB group, 5 patients (4.7%) had non-neoplasms, all of which were nodular hyperplasia. Moreover, the CNB group showed a significantly higher malignancy rate than FNA (57.9% versus 28%, p < 0.001).
  
  
  CONCLUSIONS
  CNB showed a significantly lower false-positive rate and a higher malignancy rate than FNA in diagnosing FN. Therefore, CNB could minimize unnecessary surgery and provide diagnostic confidence when managing patients with FN to perform surgery.
authors.affiliation: 1 Department of Radiology and the Research Institute of Radiology, University of Ulsan College of Medicine , Asan Medical Center, Seoul, Korea.
authors.forename: Ra Gyoung
authors.initials: RG
authors.lastname: Yoon
authors.forename: Jung Hwan
authors.initials: JH
authors.lastname: Baek
authors.forename: Jeong Hyun
authors.initials: JH
authors.lastname: Lee
authors.forename: Young Jun
authors.initials: YJ
authors.lastname: Choi
authors.forename: Min Ji
authors.initials: MJ
authors.lastname: Hong
authors.forename: Dong Eun
authors.initials: DE
authors.lastname: Song
authors.forename: Jae Kyun
authors.initials: JK
authors.lastname: Kim
authors.forename: Jong Ho
authors.initials: JH
authors.lastname: Yoon
authors.forename: Won Bae
authors.initials: WB
authors.lastname: Kim
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000473:pathology* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D062005:Biopsy, Large-Core Needle; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013961:Thyroid Gland / Q000473:pathology / Q000601:surgery; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery; D019564:Unnecessary Procedures; D055815:Young Adult