Effectiveness of core-needle US-guided biopsy as a primary tool for diagnosis of thyroid nodules

Background In many nodular thyroid cases, fine-needle biopsy (FNB) under the guidance of ultrasound (US) has been a primary diagnostic test as it is a safe, minimally invasive method with a low cost. However, it may have "nondiagnostic" aspirates because of the sampling difficulties. On the other hand, a bigger tissue sample is obtained by core-needle biopsy (CNB), which can promote more precise diagnostic results with a reduction of the need for repeated aspiration. Methods In a case-series study, adult patients with suspicious thyroid nodules were assigned to a preoperative diagnosis by both US-guided FNB and CNB with correlation to the final postoperative pathology diagnosis. Results CNB had more accuracy in thyroid malignancy diagnosis (95.8%) than FNB (75%). Nondiagnostic results could be lessened by CNB more than FNB with calculated sensitivities of 70% and 90% and specificities of 80% and 100% for FNB and CNB, respectively. No significant complications resulted while acquiring the samples for both modalities. Conclusion US-guided CNB was more specific than FNB in the diagnosis of thyroid malignancy. A combination of FNB/CNB would be more precise than performing CNB only or FNB in nodular thyroid disease.