Apart from the various benefits of core-needle biopsy (CNB) for the diagnosis of thyroid nodules, we believe that our paper has clinical significance in the diverse presentation of six categories of the pathology reporting system for thyroid CNB according to pathologic criteria [2-6].

We would like to respond to your thoughtful comments as follows. First, it was unfortunate that our pathologic analysis was not based on the 2019 clinical practice guidelines for CNB, but those guidelines were not published until after we prepared our paper [7]. We agree that the nondiagnostic criteria of the 2019 clinical practice guidelines are more reasonable, and our nondiagnostic rate of 1.8% might have been higher if the new criteria were applied. Second, we agree with your comment that the relatively high malignancy rate (23.1%) in the nondiagnostic category of our data might have been related to the assumption that many nondiagnostic cases might be lost to follow-up or categorized as "other" because the pathologic criteria in our paper did not follow the new CNB guidelines [8]. Nonetheless, we still think that even CNB has the potential to miss malignancies because a small malignant portion of thyroid nodules categorized as nondiagnostic using CNB could miss being targeted in the CNB procedure. Finally, we wholeheartedly agree with your comment that we need to reduce the unnecessary biopsy rate in our daily practice, and we believe that CNB will reduce the unnecessary biopsy rate compared with fine-needle aspiration by decreasing the need for repeated biopsies, as stated in our paper.