Purp

ose:

oTo

ass

ess

the

safe

ty a

nd a

dequ

acy

of C

ore

Nee

dle

Biop

sy o

f Thy

roid

nodu

les.

Mat

eria

lsan

dm

etho

ds:

oR

etro

spec

tive

stud

y, pa

tient

radi

olog

yno

tes

and

disc

harg

e no

tes

revi

ewed

oD

ata

item

s co

llect

ed:

ode

partm

enta

l dat

abas

ein

terro

gate

d to

col

lect

abr

eakd

own

of a

ll th

yroi

d bi

opsi

espe

rform

ed o

ver t

ime

perio

d of

past

8 m

onth

s.o

Rev

iew

ed p

atie

nt d

isch

arge

note

s -r

evie

w d

etai

ls o

f con

sent

,cl

ottin

g do

cum

enta

tion,

proc

edur

al d

etai

ls in

clud

ing

num

ber o

f pas

ses,

nee

dle

type

and

core

siz

e, o

pera

tor,

right

/ lef

tlo

be/is

thm

us.

ode

tails

of p

ost –

proc

edur

alco

mpl

icat

ions

and

fina

l his

tolo

gyre

port.

oD

ata

anal

yzed

and

tabu

late

d.

Res

ults

:

oAl

lbio

psie

sw

ere

done

with

an18

G6c

mne

edle

with

anad

just

able

varia

ble

(10

or20

mm

)not

chsi

ze.

Tran

s-is

thm

icap

proa

chw

asus

edas

fara

spo

ssib

le.

oTw

enty

-six

biop

sies

done

from

20no

dule

s.N

odul

esi

zera

ngin

gfro

m14

to55

mm

.Lob

ardi

strib

utio

nas

illust

rate

dab

ove.

oAg

eof

the

patie

nts

rang

edbe

twee

n29

-94

year

sw

itha

mea

nag

eof

63ye

ars.

Abou

t70%

(n=1

4)pa

tient

sw

ere

Fem

ale

and

30%

(n=6

)Mal

e.

oO

fthe

20pa

tient

s,9

(45%

)had

atle

asto

nepr

evio

usin

adeq

uate

FNA,

3(1

5%)h

adno

prio

rFN

Ado

nean

d8

(40%

)had

apo

sitiv

epr

iorF

NA.

oTw

enty

-four

(92.

3%)o

fth

e26

sam

ples

wer

ead

equa

teto

prov

ide

ahi

stol

ogic

aldi

agno

sis.

Two

sam

ples

(7.7

%)w

ere

inad

equa

te/n

ondi

agno

stic

.

oLa

rger

nodu

les

allo

wed

larg

eran

dm

ultip

leco

res

tobe

obta

ined

,mul

tiple

core

sw

ere

obta

ined

inab

out2

0%(n

=4)o

fpat

ient

sas

oppo

sed

tosi

ngle

core

sin

the

rem

aini

ng80

%(n

=16)

.

oTh

edi

strib

utio

nof

sam

ples

amon

gth

e10

vs20

mm

core

sw

aseq

ual.

The

adeq

uacy

ofth

esa

mpl

esw

as10

0%in

the

long

er20

mm

core

sVs

84.6

%in

the

10m

mco

resa

mpl

es.T

hetw

ono

ndi

agno

stic

sam

ples

wer

ebo

th10

mm

core

s,fu

rther

,th

ese

nodu

les

had

am

ore

cyst

icco

mpo

nent

than

the

othe

rs.

oO

fthe

24ad

equa

tesa

mpl

es,1

9(7

9.2%

)wer

ebe

nign

,3(1

2.5%

)wer

em

alig

nant

,2(8

.3%

)sho

wed

follic

ular

neop

lasm

,one

ofw

hich

was

oper

ated

and

conf

irmed

Follic

ular

carc

inom

a.

oN

oM

ajor

com

plic

atio

nsw

ere

obse

rved

,1

patie

nt(0

.05%

)ha

da

foca

lhe

mat

oma

,m

anag

edco

nser

vativ

ely

and

did

notp

rogr

ess.

Con

clus

ions

:o

Thyr

oid

CN

B is

a s

afe

and

rapi

dm

etho

d to

eva

luat

e th

yroi

d no

dule

s.o

It is

esp

ecia

lly u

sefu

l for

nod

ules

with

prio

r non

-dia

gnos

tic F

NA

and

for p

atie

nts

with

ben

ign

nodu

les

who

wan

t to

avoi

d a

diag

nost

i che

mith

yroi

dect

omy.

oAl

thou

gh it

s sa

fety

is w

ell

docu

men

ted,

No

guid

elin

es e

xist

for

Thyr

oid

CN

B as

a fi

rst l

ine

indi

agno

sis.

DrPrasha

ntGup

ta

Depa

rtmen

tOfR

adiology,Scuntho

rpeGe

neralH

ospital,CliffGarde

ns,

DN157B

H.

Ref

eren

ces:

1.H

a EJ

, Bae

kJH

, Lee

JH

, et a

l.C

ompl

icat

ions

follo

win

g U

S-gu

ided

cor

e-ne

edle

bio

psy

for

thyr

oid

lesi

ons:

a re

trosp

ectiv

e st

udy

of 6

,169

cons

ecut

ive

patie

nts

with

6,6

87 th

yroi

d no

dule

s.Eu

rope

an ra

diol

ogy

2017

;27:

1–9.

doi:1

0.10

07/s

0033

0-01

6-44

61-9

2.Pa

jaM

, del

Cur

aJL

, Zab

ala

R, e

t al.

Ultr

asou

nd-

guid

ed c

ore-

need

le b

iops

y in

thyr

oid

nodu

les.

Ast

udy

of 6

76 c

onse

cutiv

e ca

ses

with

sur

gica

lco

rrela

tion.

Eur

opea

n ra

diol

ogy

2016

;26:

1–8.

doi:1

0.10

07/s

0033

0-01

5-38

21-1

3.H

a EJ

, Bae

kJH

, Lee

JH

, et a

l.C

ore

need

lebi

opsy

can

min

imis

e th

e no

n-di

agno

stic

resu

lt san

d ne

ed fo

r dia

gnos

tic s

urge

ry in

pat

ient

s w

ithca

lcifi

ed th

yroi

d no

dule

s. E

urop

ean

radi

olog

y20

14;2

4:14

03–9

. doi

:10.

1007

/s00

330-

014-

3123

-z

4.Su

h, C

. H.,

Baek

, J. H

., Le

e, J

. H.,

Cho

i, Y.

J.,

Kim

, J. K

., Su

ng, T

.-Y.,

… S

hong

, Y. K

. (20

16) .

The

Rol

e of

Cor

e-N

eedl

e Bi

opsy

as

a Fi

rst-L

ine

Dia

gnos

tic T

ool f

or In

itial

ly D

etec

ted

Thyr

oid

Nod

ules

. Thy

roid

, 26(

3), 3

95–4

03.

http

://do

i.org

/10.

1089

/thy.2

015.

0404

5.C

hen,

B.,

Jain

, A.,

Dag

is, A

., C

hu, P

., Vo

ra, L

.,M

agha

mi,

E., &

Sal

ehia

n, B

. (20

15).

Com

paris

onof

the

Effic

acy

and

Safe

ty o

f Ultr

asou

nd-G

uide

dC

ore

Nee

dle

Biop

sy V

ersu

s Fi

ne-N

eedl

eAs

pira

tion

for E

valu

atin

g Th

yroi

d N

odul

es.

Endo

crin

e Pr

actic

e, 2

1(2)

, 128

–135

.ht

tp://

doi.o

rg/1

0.41

58/E

P143

03.O

R

Ade

quac

y an

d Sa

fety

of T

hyro

id C

ore

Nee

dle

Bio

psy

(CN

B)