Kyung Sik Yi MD, Presenter: Nothing to Disclose

Ji Hoon Kim MD, Abstract Co-Author: Nothing to Disclose

Dong Gyu Na, Abstract Co-Author: Nothing to Disclose

Chul-Ho Sohn MD, Abstract Co-Author: Nothing to Disclose

Seung Hong Choi MD, PhD, Abstract Co-Author: Nothing to Disclose

Tae Jin Yun MD, Abstract Co-Author: Nothing to Disclose

Hyo Bin Seo, Abstract Co-Author: Nothing to Disclose

Macrocalcification in thyroid nodule has been known to be an important factor related to high inadequate sample rate of fine-needle aspiration (FNA). Recently, core-needle biopsy (CNB) has been reported to be useful in patients with nondiagnostic reading in prior FNA. The purpose of the study was to determine whether CNB provides better diagnostic information for thyroid nodules with macrocalcification in initial and repeat workups as compared with FNA. 

The study included 111 thyroid nodules with macrocalcification from 108 consecutive patients who underwent FNA and CNB simultaneously for each nodule. The final diagnoses of thyroid nodules were obtained in 62 nodules (benign 34, malignant 28). Two blinded radiologists retrospectively evaluated ultrasonographic features of nodule size, echogenicity, and proportion of calcification in entire nodule volume and analyzed the association between these features and inadequate samples in FNA and CNB. The nondiagnostic readings of FNA and CNB were compared. The diagnostic sensitivities of FNA, CNB and combination of FNA and CNB for malignancy in thyroid nodules were also assessed. 

Larger proportion of calcification than 1/3 in entire nodule volume is the only factor for nondiagnostic reading in FNA (p=0.024). The nondiagnostic readings of CNB were lower than those of FNA in initial group (1.5% vs. 24.2%, p<0.001) and repeat group (2.2% vs. 33.3%, p<0.001). The sensitivity of combination of FNA and CNB for thyroid malignancy was significantly higher than FNA alone in initial group (95.7% vs. 78.3%, p=0.008) and repeat group (100% vs. 80.0%). 

In initial and repeat workups of thyroid nodules with macrocalcification, CNB is more useful to reduce nondiagnostic reading and to diagnose thyroid malignancy than FNA.

In initial and repeat workups of thyroid nodules with macrocalcification, core-needle biopsy is more useful to reduce nondiagnostic reading and to diagnose malignancy than fine-needle aspiration.

Yi, K, Kim, J, Na, D, Sohn, C, Choi, S, Yun, T, Seo, H, Usefulness of Core-Needle Biopsy of Thyroid Nodules with Macrocalcification in Initial and Repeat Workups: Comparison with Fine Needle Aspiration.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12028128.html