{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T14:36:32Z","timestamp":1782311792421,"version":"3.54.5"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T00:00:00Z","timestamp":1761264000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We aimed to evaluate and compare the efficacies and roles of core-needle biopsy (CNB) and repeat fine-needle aspiration (rFNA) in diagnosing thyroid nodules initially diagnosed as atypia of undetermined significance (AUS) by FNA. Additionally, we aimed to investigate the potential of CNB in diagnosing non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) and other follicular neoplasms (FNs), addressing its advantages over FNA in overcoming the diagnostic limitations of FNA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Overall, 635 nodules (7.3%) initially diagnosed as AUS were retrospectively reviewed from among 8,670 thyroid FNAs that were performed between 2018 and 2021. Malignancy rates were calculated as upper and lower limit estimates. rFNA was performed on 315 AUS nodules, and CNB was conducted on 62 patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Comparing the outcomes, CNB showed significantly fewer non-diagnostic results than rFNA (0% vs. 44.4%, p = 0.008) and a higher rate of FN diagnosis (11.3% vs. 0.3%, p &amp;lt; 0.001). In the AUS category, CNB demonstrated higher diagnostic rates for FNs, including NIFTP and follicular variant papillary thyroid carcinoma (50% vs. 18%). CNB significantly reduced the rate of insufficient diagnoses and increased the rate of diagnosing FNs. Moreover, CNB proved more effective than rFNA in diagnosing FNs, including NIFTP, within the AUS category, ensuring accurate detection without underdiagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CNB may serve as a more reliable diagnostic tool for cases initially classified as AUS, particularly when repeat insufficient results are obtained or when diagnosing FNs and NIFTP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2025.1692071","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T04:14:38Z","timestamp":1761279278000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Malignancy risk in AUS thyroid lesions: comparison between FNA and CNB with implications for NIFTP diagnosis"],"prefix":"10.3389","volume":"16","author":[{"given":"Yeseul","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Ho","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"You-Na","family":"Sung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawon","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harim","family":"Oh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyo Seon","family":"Ryu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyeong Jin","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun Joo","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sin Gon","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoon Yub","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwang Yoon","family":"Jung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung-Kuk","family":"Baek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangjeong","family":"Ahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1089\/thy.2015.0020","article-title":"2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the american thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer","volume":"26","author":"Haugen","year":"2016","journal-title":"Thyroid"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2023.0141","article-title":"The 2023 bethesda system for reporting thyroid cytopathology","volume":"33","author":"Ali","year":"2023","journal-title":"Thyroid."},{"key":"B3","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1002\/cncy.20029","article-title":"The indeterminate thyroid fine-needle aspiration: experience from an academic center using terminology similar to that proposed in the 2007 National Cancer Institute Thyroid Fine Needle Aspiration State of the Science Conference","volume":"117","author":"Nayar","year":"2009","journal-title":"Cancer."},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22955","article-title":"Fine-needle aspiration of thyroid nodules: a study of 4703 patients with histologic and clinical correlations","volume":"111","author":"Yang","year":"2007","journal-title":"Cancer."},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23116","article-title":"Long-term assessment of a multidisciplinary approach to thyroid nodule diagnostic evaluation","volume":"111","author":"Yassa","year":"2007","journal-title":"Cancer."},{"key":"B6","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1002\/cncy.20178","article-title":"The atypical thyroid fine-needle aspiration: past, present, and future","volume":"120","author":"Bongiovanni","year":"2012","journal-title":"Cancer Cytopathol."},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.4158\/EP.13.7.735","article-title":"Value of repeating a nondiagnostic thyroid fine-needle aspiration biopsy","volume":"13","author":"Orija","year":"2007","journal-title":"Endocr Pract"},{"key":"B8","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/1742-6413-3-9","article-title":"Fine-needle aspiration of follicular lesions of the thyroid. 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