Hasannia Mohammad Ali, Pourghorban Ramin, Asefi Hoda, Aria Amir, Nazar Elham, Ebrahiminik Hojat, Mohamadian Alireza
Department of Radiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran.
J Pathol Transl Med. 2025 May;59(3):180-187. doi: 10.4132/jptm.2025.03.04. Epub 2025 Apr 16.
Fine needle aspiration (FNA) is a widely utilized technique for assessing thyroid nodules; however, its inherent non-diagnostic rate poses diagnostic challenges. The present study aimed to evaluate and compare the diagnostic efficacy of FNA, core needle biopsy (CNB), and their combined application in the assessment of thyroid nodules.
A total of 56 nodules from 50 patients was analyzed using both FNA and simultaneous CNB. The ultrasound characteristics were categorized according to the American College of Radiology Thyroid Imaging Reporting and Data Systems classification system. The study compared the sensitivity, specificity, and accuracy of FNA, CNB, and the combination of the two techniques.
The concordance between FNA and CNB was notably high, with a kappa coefficient of 0.837. The sensitivity for detecting thyroid malignancy was found to be 25.0% for FNA, 66.7% for CNB, and 83.3% for the combined FNA/CNB approach, with corresponding specificities of 84.6%, 97.4%, and 97.4%. The accuracy of the FNA/CNB combination was the highest at 94.1%.
The findings of this study indicate that both CNB and the FNA/CNB combination offer greater diagnostic accuracy for thyroid malignancy compared to FNA alone, with no significant complications reported. Integrating CNB with FNA findings may enhance management strategies and treatment outcomes for patients with thyroid nodules.
细针穿刺抽吸术(FNA)是评估甲状腺结节广泛应用的技术;然而,其固有的非诊断率带来了诊断挑战。本研究旨在评估和比较FNA、粗针活检(CNB)及其联合应用在评估甲状腺结节中的诊断效能。
对50例患者的56个结节同时采用FNA和CNB进行分析。根据美国放射学会甲状腺影像报告和数据系统分类系统对超声特征进行分类。本研究比较了FNA、CNB以及两种技术联合应用的敏感性、特异性和准确性。
FNA与CNB之间的一致性显著较高,kappa系数为0.837。发现FNA检测甲状腺恶性肿瘤的敏感性为25.0%,CNB为66.7%,FNA/CNB联合方法为83.3%,相应的特异性分别为84.6%、97.4%和97.4%。FNA/CNB联合应用的准确性最高,为94.1%。
本研究结果表明,与单独使用FNA相比,CNB以及FNA/CNB联合应用对甲状腺恶性肿瘤具有更高的诊断准确性,且未报告明显并发症。将CNB与FNA结果相结合可能会改善甲状腺结节患者的管理策略和治疗效果。