Advantages of thyroid core needle biopsy: an emerging selective first-line biopsy modality

Ultrasound-guided fine needle aspiration biopsy (FNAB) for thyroid lesions has proven safe and effective; however, FNAB has limitations, including the frequent occurrence of nondiagnostic and inconclusive results and technical challenges in specific clinical scenarios. To address these limitations, core needle biopsy (CNB) was introduced, and substantial advancements have been made in CNB devices and techniques. Evidence from large patient cohorts indicates that CNB is not only safe and reliable but also provides superior diagnostic accuracy compared with FNAB. This review discusses recent advancements in CNB techniques to optimize tissue sampling, the diagnostic performance of CNB, and patient-centered perspectives, highlighting the potential of CNB as a selective first-line biopsy modality.