Core needle biopsy for thyroid nodules assessment-a new horizon?

Abstract

Ultrasound-guided fine-needle aspiration is the standard for evaluating thyroid nodules with a high safety profile and a relatively low number of non-diagnostic cytological findings. Nevertheless, this diagnostic method traditionally has its weak points. Several diagnostic categories such as Bethesda I, III and IV are not reliable for thyroid carcinoma risk assessment. Recent advancements in a core needle biopsy made it possible to use this tool as a new method for thyroid nodules evaluation. The main feature of this method is the use of thin needles (18-21G) and guns with an automatic trigger mechanism. The histological material collected with the use of a core needle biopsy is usually superior to cytological. Therefore, the core needle biopsy can be used as a complementary technique to a standard fine needle aspiration in difficult and dubious cases of thyroid neoplasia with uncertain malignant potential.

Keywords: Core-needle biopsy; Fine-needle aspiration; Follicular tumor; Thyroid; Thyroid cancer.

Figure 1

Ultrasonography-guided core-needle biopsy of the thyroid gland. A: Assessment of the size of the mass; B: Assessment in the Doppler mode; C: Marking the optimal trajectory for core-needle biopsy (CNB); D: Calculation of the distance till the mass and major vessels; E: Control of the needle along its length; F: Control during the biopsy; G: Assessment of the mass after CNB; H: Assessment of the node in Doppler mode after CNB.

Figure 2

Core-needle biopsy of a thyroid node may be marginal 2 or through the node 1.