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Molecular testing for indeterminate thyroid nodules: past, present, and future.

Rajam Raghunathan¹, Stephanie Smooke Praw², Masha Livhits¹

¹Section of Endocrine Surgery.

Current Opinion in Endocrinology, Diabetes, and Obesity

|August 2, 2023

Summary

This summary is machine-generated.

Molecular testing for indeterminate thyroid nodules improves accuracy and reduces unnecessary surgeries. Ongoing research aims to enhance test reliability and cost-effectiveness for better patient care.

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Area of Science:

Endocrinology
Oncology
Genetics

Background:

Indeterminate thyroid nodules (Bethesda III/IV) pose diagnostic challenges, often leading to unnecessary surgeries.
Molecular testing offers a less invasive approach to risk stratification.

Approach:

Review of current molecular testing platforms for thyroid nodules.
Analysis of diagnostic performance, including benign call rates and specificity.
Evaluation of challenges and future directions in molecular diagnostics.

Key Points:

Current genomic tests show improved diagnostic performance over previous versions.
Test selection should balance performance, malignancy rates, cytology, and prognostication.
Challenges include test reliability, surveillance duration, and performance in specific nodule types (oncocytic, NIFTP).

Conclusions:

Molecular testing reduces the need for diagnostic surgery, lowering costs and complications.
While performance has improved, further refinement in test scope and reliability is needed.
Integrated decision-making considers cytology, clinical features, patient preferences, and molecular results.