Abstract

Ultrasound (US)-guided fine needle aspiration biopsy (FNA) is currently the most common diagnostic method for determining surgical cases and preventing unnecessary surgery as it is easy, reliable and cost-effective. However, current multi-center studies indicate that about 5-47% of the cases that have undergone FNA are evaluated as inadequate/indeterminate for diagnosis due to factors related to the assessor, the technique and the pathologist's experience. It is reported that using US-guided percutaneous core needle biopsy (CNB) is useful, especially in cases where diagnostic surgery is planned as the cases have been reported as ‘Inadequate for diagnosis’ or ‘Atypia with unclear in significance/ Follicular lesion with unclear in significance(AUS/FLUS) after inadequate repetitive FNA results. Using FNA and CNB together has been reported to provide higher diagnostic sensitivity than either method alone in certain studies. The aim of this study is prospective evaluation of simultaneous US-guided FNA and CNB results of 44 cases who had thyroid nodules. All cases were evaluated according to the TIRADS classification used for sonographic malignancy risk categorization and recorded together with the demographic data (age/gender). FNAs were evaluated according to the Bethesda classification. We tried to adapt the results of the evaluated CNBs descriptively to the Bethesda classification to facilitate comparison of the methods. In our study, when the inadequate and indeterminate diagnosis groups were separated, all our cases diagnosed as benign and malignant with FNA and CNB were compliant. However, the ratio of insufficiency shows a significant elevation compared to CNB in our FNA procedures (4.54% vs. 43.18%). We observed that simultaneous FNA and CNB use decreased the inadequate/ indeterminate diagnosis group significantly.