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Meta-Analysis
. 2017 Jan;27(1):431-436.
doi: 10.1007/s00330-016-4356-9. Epub 2016 Apr 18.

Comparison of diagnostic yield of core-needle and fine-needle aspiration biopsies of thyroid lesions: Systematic review and meta-analysis

Kosma Wolinski  1 , Adam Stangierski  2 , Marek Ruchala  2
Affiliations
Meta-Analysis

Comparison of diagnostic yield of core-needle and fine-needle aspiration biopsies of thyroid lesions: Systematic review and meta-analysis

Kosma Wolinski et al. Eur Radiol. 2017 Jan.

Abstract

Objectives: Thyroid nodular disease is one of the most commonly observed medical conditions. Cytological evaluation of the specimens obtained with fine-needle aspiration biopsy (FNAB) is the most accurate tool for selecting nodules which should be further surgically removed. A major limitation of this method is the high occurrence of non-diagnostic results. This indicates the need for improvement of the thyroid biopsy technique. The aim of this meta-analysis was to compare the diagnostic value of thyroid core-needle biopsies (CNBs) and FNABs.

Materials and methods: PubMed/MEDLINE, Cochrane Library, Scopus, Cinahl, Academic Search Complete, Web of Knowledge, PubMed Central, PubMed Central Canada and Clinical Key databases were searched. Risk ratios (RRs) of non-diagnostic results were meta-analysed using the random-effects model.

Results: Eleven studies were included in the quantitative analysis. CNB yielded significantly more diagnostic results - the pooled risk ratio (RR) of gaining a non-diagnostic result was 0.27 (p<0.0001). For lesions with one previous non-diagnostic FNAB, RR was 0.22 (p<0.0001).

Conclusions: CNB seems to be a valuable diagnostic technique yielding a higher proportion of diagnostic results than conventional FNAB. It is also significantly more effective in case of nodules with a prior non-diagnostic result of FNAB results than repeated FNABs.

Key points: • Core-needle biopsy yields a higher proportion of diagnostic results than fine-needle biopsy. • Core-needle biopsies may decrease the amount of unnecessary thyroidectomies. • Probability of gaining non-diagnostic result using core-needle biopsy is almost four times lower.

Keywords: Biopsy; Core-needle biopsy; Fine-needle aspiration biopsy; Thyroid· Thyroid lesions.

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Figures

Fig. 1
Fig. 1
Flowchart showing the steps included in the literature search and selection
Fig. 2
Fig. 2
Forest plot showing individual and pooled risk ratios (RRs) of gaining non-diagnostic results with core-needle biopsy in comparison to fine-needle aspiration biopsy; with 95 % confidence intervals and p-values given in columns 2–4
Fig. 3
Fig. 3
Cumulative forest plot for studies comparing risk ratios (RRs) of gaining non-diagnostic results with core-needle biopsy in comparison to fine-needle aspiration biopsy; with 95 % confidence intervals and p-values given in columns 2–4
See this image and copyright information in PMC

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