Accuracy of Thyroid Fine-Needle Biopsy Unchanged Over 40 Years, Study Finds

Despite updates to the use of thyroid fine-needle biopsy (FNB) for thyroid nodule diagnosis over the past few decades, the accuracy of the procedure has remained largely unchanged though it continues to be a reliable test for thyroid cancer diagnosis, according to a study in JAMA Surgery this week. Since thyroid FNB became a key part of thyroid malignancy diagnosis in the late 1970s, there have been numerous improvements in the way the procedure is performed including the use of ultrasound guidance, rapid on-site cytopathologic evaluation, and refinements to cytopathology sample preparation and the interpretation of results. Yet the impact these changes have had on the accuracy of FNB testing is not known. To investigate, a team led by scientists from the University of Wisconsin-Madison performed a systematic review and meta-analysis of relevant peer-reviewed research and clinical trial reports obtained from PubMed, SCOPUS, and the Cochrane Central Register of Controlled Trials between 1975 and 2020. They find that the accuracy of thyroid FNB has not significantly changed over time, as the overall sensitivity and specificity estimates for the procedure at 85.6 percent and 71.4 percent, respectively. Still, "FNB remains an efficient, relatively noninvasive, and affordable method for determining the next step in the management of undifferentiated thyroid nodule," the authors write