A prospective controlled study of fine-needle aspiration and Tru-cut® needle biopsy of dominant thyroid nodules

Abstract

In order to evaluate the relative merits of fine-needle aspiration (FNA) and Tru-cut® needle biopsy (TNB), we conducted a prospective controlled trial in 384 patients who had dominant thyroid nodules. FNA had a slightly higher diagnostic yield and fewer complications than TNB. Definitive confirmation of the biopsy diagnoses was obtained in 41.1% of the patients. Both techniques achieved a very high degree of overall accuracy, and false-positive errors among non-follicular lesions occurred only in cases labeled as possibly malignant. However, neither method could reliably distinguish between a benign and malignant follicular neoplasm. Including follicular neoplasms as suspicious for malignancy, the individual sensitivity rates for cancer were 86.5% and 91.9% for FNA and TNB, respectively. The combined use of FNA and TNB, however, detected 97.3% of the 37 malignancies. Rather than demonstrating any overwhelming relative advantage, this study would support the use of both FNA and TNB to investigate dominant nodules. When combined with clinical information and imaging studies, needle biopsy can reduce the number of unnecessary operations without seriously compromising the removal of thyroid cancers.