Comparison of Core-Needle Biopsy and Fine-Needle Aspiration for Evaluating Thyroid Incidentalomas Detected by F-18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography: A Propensity Score Analysis

作者：Suh Chong Hyun; Choi Young Jun^*; Lee Jong Jin; Shim Woo Hyun; Baek Jung Hwan; Chung Han Cheol; Shong Young Kee; Song Dong Eun; Sung Tae Yon; Lee Jeong Hyun

来源：Thyroid, 2017, 27(10): 1258-1266.

DOI：10.1089/thy.2017.0192

• core-needle biopsy
• fine-needle aspiration
• thyroid incidentalomas
• F-18-FDG PET/CT
• propensity score analysis
• ultrasound

Background: This study used a propensity score analysis to assess the roles of core-needle biopsy (CNB) and fine-needle aspiration (FNA) in the evaluation of thyroid incidentalomas detected on F-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT).
Methods: The study population was obtained from a historical cohort who underwent F-18-FDG PET/CT between October 2008 and September 2015. Patients were included who underwent ultrasound-guided CNB or FNA for incidental focal uptake of F-18-FDG in the thyroid gland on PET/CT. The primary study outcomes included the inconclusive result rates in the CNB and FNA groups. The secondary outcome measures included the non-diagnostic result rate and the diagnostic performance for neoplasms. Multivariate analysis, propensity score matching, and inverse probability weighting were conducted.
Results: A total of 1360 nodules from 1338 patients were included in this study: 859 nodules from 850 patients underwent FNA, and 501 nodules from 488 patients underwent CNB. Compared to FNA, CNB demonstrated a significantly lower inconclusive result rate in the pooled cohort (23.8% vs. 35.4%; p<0.001), propensity score-matched cohorts (22.9% vs. 36.6%; p<0.001), and with inverse probability weighting (22.4% vs. 35.2%; p<0.001). Non-diagnostic result rates were also significantly lower in CNB than in FNA. The diagnostic performance of the two groups in the pooled and matched cohorts was similar, with no significant differences found.
Conclusions: The significantly lower inconclusive result rates in CNB than in FNA were consistent within the propensity score-matched cohorts. Therefore, CNB appears to be a promising diagnostic tool for patients with thyroid incidentalomas detected on F-18-FDG PET/CT.

• 出版日期2017-10