Assessment of the risk of malignancy in Bethesda III thyroid nodules: a comprehensive review

Karthik Nagaraja Rao¹, Gregory W Randolph², Fernando Lopez³, Mark Zafereo⁴, Andrés Coca-Pelaz³, Cesare Piazza⁵, Prajwal Dange⁶, Juan Pablo Rodrigo³, Göran Stenman⁷, Bart de Keizer⁸, Iain Nixon⁹, Shriyash Sinha⁶, Sophie Leboulleux¹⁰, Antti A Mäkitie^{11

12}, Abbas Agaimy^{13

14}, Lester Thompson¹⁵, Alfio Ferlito¹⁶; This paper was written by members and invitees of the International Head and Neck Scientific Group

Affiliations

¹ Department of Head and Neck Oncology, Sri Shankara Cancer Hospital and Research Center, Bangalore, 560004, India. karthik.nag.rao@gmail.com.
² Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
³ Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, ISPA, IUOPA, CIBERONC, 33011, Oviedo, Spain.
⁴ Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
⁵ Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy.
⁶ Department of Head and Neck Oncology, Sri Shankara Cancer Hospital and Research Center, Bangalore, 560004, India.
⁷ Sahlgrenska Center for Cancer Research Department of Pathology, University of Gothenburg, Gothenburg, Sweden.
⁸ Department of Nuclear Medicine and Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
⁹ Department of Surgery and Otolaryngology, Head and Neck Surgery, Edinburgh University, Edinburgh, EH3 9YL, UK.
¹⁰ Department of Endocrinology, Diabetology, Nutrition and Therapeutic Education, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva University, Geneva, Switzerland.
¹¹ Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
¹² Research Program in Systems Oncology, University of Helsinki, Helsinki, Finland.
¹³ Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany.
¹⁴ Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054, Erlangen, Germany.
¹⁵ Head and Neck Pathology Consultations, Woodland Hills, CA, 91364, USA.
¹⁶ Coordinator of the International Head and Neck Scientific Group, Padua, Italy.

PMID: 38416380
DOI: 10.1007/s12020-024-03737-z

Review

Assessment of the risk of malignancy in Bethesda III thyroid nodules: a comprehensive review

Karthik Nagaraja Rao et al. Endocrine. 2024 Aug.

. 2024 Aug;85(2):473-492.

doi: 10.1007/s12020-024-03737-z. Epub 2024 Feb 28.

Authors

Affiliations

¹ Department of Head and Neck Oncology, Sri Shankara Cancer Hospital and Research Center, Bangalore, 560004, India. karthik.nag.rao@gmail.com.
² Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
³ Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, ISPA, IUOPA, CIBERONC, 33011, Oviedo, Spain.
⁴ Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
⁵ Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy.
⁶ Department of Head and Neck Oncology, Sri Shankara Cancer Hospital and Research Center, Bangalore, 560004, India.
⁷ Sahlgrenska Center for Cancer Research Department of Pathology, University of Gothenburg, Gothenburg, Sweden.
⁸ Department of Nuclear Medicine and Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
⁹ Department of Surgery and Otolaryngology, Head and Neck Surgery, Edinburgh University, Edinburgh, EH3 9YL, UK.
¹⁰ Department of Endocrinology, Diabetology, Nutrition and Therapeutic Education, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva University, Geneva, Switzerland.
¹¹ Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
¹² Research Program in Systems Oncology, University of Helsinki, Helsinki, Finland.
¹³ Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany.
¹⁴ Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054, Erlangen, Germany.
¹⁵ Head and Neck Pathology Consultations, Woodland Hills, CA, 91364, USA.
¹⁶ Coordinator of the International Head and Neck Scientific Group, Padua, Italy.

PMID: 38416380
DOI: 10.1007/s12020-024-03737-z

Abstract

The increasing prevalence of thyroid cancer emphasizes the need for a thorough assessment of risk of malignancy in Bethesda III nodules. Various methods ranging commercial platforms of molecular genetic testing (including Afirma® GEC, Afirma® GSC, ThyroSeq® V3, RosettaGX®, ThyGeNEXT®/ThyraMIR®, ThyroidPRINT®) to radionuclide scans and ultrasonography have been investigated to provide a more nuanced comprehension of risk estimation. The integration of molecular studies and imaging techniques into clinical practice may provide clinicians with improved and personalized risk assessment. This integrated approach we feel may enable clinicians to carefully tailor interventions, thereby minimizing the likelihood of unnecessary thyroid surgeries and overall crafting the optimal treatment. By aligning with the evolving landscape of personalized healthcare, this comprehensive strategy ensures a patient-centric approach to thyroid nodule and thyroid cancer management.

Keywords: Artificial intelligence; Bethesda system; Molecular testing; Risk assessment; Thyroid neoplasms.

PubMed Disclaimer

References

1. M. Li, L. Dal Maso, S. Vaccarella, Global trends in thyroid cancer incidence and the impact of overdiagnosis. Lancet Diabetes Endocrinol. 8(6), 468–470 (2020) - PubMed
1. M. Uludag, M.T. Unlu, M. Kostek, N. Aygun, O. Caliskan, A. Ozel et al. Management of thyroid nodules. Sisli Etfal Hastan Tip Bul. 57(3), 287–304 (2023) - PubMed - PMC
1. S.Z. Ali, Z.W. Baloch, B. Cochand-Priollet, F.C. Schmitt, P. Vielh, P.A. VanderLaan, The 2023 Bethesda system for reporting thyroid cytopathology. Thyroid® 33(9), 1039–1044 (2023) - PubMed
1. R.E. Glass, J.J. Levy, S.A. Motanagh, L.J. Vaickus, X. Liu, Atypia of undetermined significance in thyroid cytology: Nuclear atypia and architectural atypia are associated with different molecular alterations and risks of malignancy. Cancer Cytopathol. 129(12), 966–972 (2021) - PubMed
1. B.R. Haugen, E.K. Alexander, K.C. Bible, G.M. Doherty, S.J. Mandel, Y.E. Nikiforov et al. 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. Thyroid 26(1), 1–133 (2016) - PubMed - PMC

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
- Springer
Medical
- MedlinePlus Health Information
Research Materials
- NCI CPTC Antibody Characterization Program

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Assessment of the risk of malignancy in Bethesda III thyroid nodules: a comprehensive review

Affiliations

Assessment of the risk of malignancy in Bethesda III thyroid nodules: a comprehensive review

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Research Materials