Table 1. Consensus Statement and Recommendations on Thyroid CNB from the Korean Society of Thyroid Radiology [9].
| Item | Consensus statement and recommendations |
|---|---|
| Indication of CNB | |
| R1 | CNB could be alternative to FNA in evaluation of thyroid nodules in selected cases |
| Device and procedure of CNB | |
| R2 | Modern CNB devices, particularly 18–21-gauge, spring-activated, core needles, are recommended for procedure |
| R3 | Patients with bleeding tendency, such as those taking anticoagulation medications or with disorders affecting coagulation cascade, should be thoroughly evaluated and any problems corrected before CNB |
| R4A | CNB should be performed by experienced operators under US guidance |
| R4B | Manual compression of biopsy site should be performed immediately after procedure for 20 to 30 minutes |
| Utility of CNB as a second-line alternative tool when previous FNA has indeterminate result | |
| R5 | CNB can be used as alternative to FNA for thyroid nodules with non-diagnostic cytology in previous FNA |
| R6 | CNB may be used as alternative to FNA for thyroid nodules with atypia (follicular lesion) of undetermined significance in previous FNA |
| R7A | CNB has advantages to differentiate encapsulated follicular neoplasm from non-neoplastic nodule |
| R7B | CNB cannot differentiate follicular thyroid carcinoma from follicular adenoma |
| R8 | CNB may be used as alternative to FNA for calcified thyroid nodules |
| Utility of CNB as first-line diagnostic tool | |
| R9 | CNB may achieve low rates of non-diagnostic and inconclusive results for initially detected thyroid nodules. However, utility of CNB as first-line diagnostic tool for these nodules is uncertain based on current evidence |
| Utility of CNB for cases of difficult diagnosis | |
| R10A | CNB can be used as alternative to FNA in patients with clinical and radiological features of uncommon malignancies (anaplastic carcinoma, lymphoma, or medullary carcinoma) |
| R10B | CNB can be used as alternative to FNA for thyroid nodules with US-cytology discordance in previous FNA |
| Complications of CNB | |
| R11 | CNB is safe, well-tolerated, and associated with low incidence of complications when performed by experienced operators |
CNB, core needle biopsy; FNA, fine-needle aspiration; US, ultrasound.