title: First-Line Use of Core Needle Biopsy for High-Yield Preliminary Diagnosis of Thyroid Nodules.
abstract: Although core needle biopsy was introduced as a diagnostic alternative to fine-needle aspiration, the utility and safety of core needle biopsy for thyroid nodules in a large population has yet to be studied comprehensively. We evaluate core needle biopsy yields on a large-scale basis to investigate its potential in the preliminary diagnosis of thyroid nodules.
  
  
  
  Between March 2005 and December 2013, 2448 initially detected thyroid nodules from 2120 consecutive patients who underwent core needle biopsy were retrospectively evaluated. Of these, 72 thyroid nodules from 63 patients were excluded due to prior fine-needle aspiration attempts. The inconclusive and conclusive result rates, diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and unnecessary surgery rate of core needle biopsy were evaluated.
  
  
  
  With core needle biopsy as the first-line method, the inconclusive result rate was 11.9% (283/2376) and the conclusive result rate was 88.1% (2093/2376). The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of core needle biopsy for the diagnosis of malignancy were 96.7% (1160/1200), 89.7% (347/387), 100% (813/813), 100% (347/347), and 95.3% (813/853), respectively. There were no major complications and 12 minor complications.
  
  
  
  We have demonstrated that first-line use of core needle biopsy may well improve diagnostic accuracy in thyroid nodules, reducing inconclusive or false-negative results and unnecessary operations. Such benefits underscore the promising role of core needle biopsy in managing thyroid nodules and optimizing related surgical decision-making.
authors.affiliation: From the Department of Radiology (H.C.K., Y.J.K., J.Y.S., K.W.K.), Konyang University Myunggok Medical Research Institute, Konyang Hospital, Konyang University College of Medicine, Daejeon, Republic of Korea.
authors.forename: H C
authors.identifier: 0000-0002-1319-281X
authors.initials: HC
authors.lastname: Kim
authors.affiliation: From the Department of Radiology (H.C.K., Y.J.K., J.Y.S., K.W.K.), Konyang University Myunggok Medical Research Institute, Konyang Hospital, Konyang University College of Medicine, Daejeon, Republic of Korea myth0318@hanmail.net.
authors.forename: Y J
authors.identifier: 0000-0002-7084-0289
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Department of Radiology (H.Y.H., J.M.Y.), Daejeon Sun Hospital, Daejeon, Republic of Korea.
authors.forename: H Y
authors.identifier: 0000-0003-1316-8841
authors.initials: HY
authors.lastname: Han
authors.affiliation: Department of Radiology (H.Y.H., J.M.Y.), Daejeon Sun Hospital, Daejeon, Republic of Korea.
authors.forename: J M
authors.identifier: 0000-0002-5189-7351
authors.initials: JM
authors.lastname: Yi
authors.affiliation: Department of Radiology and Research Institute of Radiology (J.H.B.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: J H
authors.identifier: 0000-0003-0480-4754
authors.initials: JH
authors.lastname: Baek
authors.affiliation: Department of Pathology (S.Y.P.), Konyang University Hospital, Konyang University College of Medicine, Daejeon, Republic of Korea.
authors.forename: S Y
authors.identifier: 0000-0002-0072-5613
authors.initials: SY
authors.lastname: Park
authors.affiliation: From the Department of Radiology (H.C.K., Y.J.K., J.Y.S., K.W.K.), Konyang University Myunggok Medical Research Institute, Konyang Hospital, Konyang University College of Medicine, Daejeon, Republic of Korea.
authors.forename: J Y
authors.identifier: 0000-0001-5354-6208
authors.initials: JY
authors.lastname: Seo
authors.affiliation: From the Department of Radiology (H.C.K., Y.J.K., J.Y.S., K.W.K.), Konyang University Myunggok Medical Research Institute, Konyang Hospital, Konyang University College of Medicine, Daejeon, Republic of Korea.
authors.forename: K W
authors.identifier: 0000-0002-7312-5483
authors.initials: KW
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D005188:False Negative Reactions; 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; D013961:Thyroid Gland / Q000473:pathology; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D016606:Thyroid Nodule / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D018084:Ultrasonography, Interventional; D019564:Unnecessary Procedures; D055815:Young Adult