Molecular testing in indeterminate thyroid nodules: an additional tool for clinical decision-making.

Area of Science:

• Endocrinology
• Oncology
• Molecular Diagnostics

Background:

• Thyroid nodules are common, with 5-15% being malignant.
• Fine needle aspiration (FNA) yields indeterminate thyroid nodule (ITN) diagnoses in 20-30% of cases.
• Managing ITNs is challenging due to variable malignancy risk (5-40%) and overtreatment risks.

Purpose of the Study:

• To review the role of molecular testing in managing indeterminate thyroid nodules.
• To address key questions regarding molecular panels' clinical utility and impact.

Main Methods:

• Review of current literature on molecular testing for thyroid nodules.
• Analysis of molecular panel performance (specificity, sensitivity, predictive values).

Main Results:

• Molecular testing can enhance the discrimination between benign and malignant nodules.
• Outstanding questions include panel utility as 'rule in'/'rule out' tools and clinical decision impact.

Conclusions:

• Molecular testing offers potential for improved ITN risk stratification.
• Further evaluation is needed on clinical integration, cost-effectiveness, and reimbursement.