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Updated: Jun 16, 2025

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Thyroid nodules: diagnosis and management.

Giorgio Grani1, Marialuisa Sponziello1, Sebastiano Filetti1

  • 1Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.

Nature Reviews. Endocrinology
|August 16, 2024
PubMed
Summary
This summary is machine-generated.

Thyroid nodules are common, affecting nearly 25% of people. Updated strategies, including imaging systems like TIRADS and molecular testing, improve risk assessment and personalize treatment for thyroid nodules.

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Area of Science:

  • Endocrinology
  • Radiology
  • Oncology

Background:

  • Thyroid nodules are highly prevalent, occurring in nearly 25% of the general population.
  • Prevalence is influenced by demographic factors and risk indicators.
  • Significant advancements in diagnostic and therapeutic protocols have emerged over the last decade.

Purpose of the Study:

  • To provide a comprehensive overview of thyroid nodule prevalence.
  • To detail current risk stratification and management strategies.
  • To highlight recent changes in diagnostic and therapeutic protocols for thyroid nodules.

Main Methods:

  • Review of sonography-based stratification systems, including Thyroid Imaging Reporting and Data Systems (TIRADS).
  • Evaluation of fine-needle aspiration biopsy (FNAB) and cytological assessment.
  • Exploration of molecular testing for indeterminate cases.
  • Assessment of evolving treatment modalities like active surveillance and local ablation.

Main Results:

  • Sonography-based systems (e.g., TIRADS) aid in malignancy risk prediction, potentially reducing biopsies.
  • Cytological evaluation via FNAB is crucial for large or suspicious nodules.
  • Molecular testing assists in managing indeterminate cytology results.
  • Non-surgical options like active surveillance and local ablation are viable alternatives for selected patients.

Conclusions:

  • Personalized, risk-based protocols enhance care quality and reduce costs for thyroid nodules.
  • Shared decision-making tools improve clinician-patient communication regarding diagnostic and treatment options.
  • Modern management strategies emphasize tailored approaches over traditional surgical interventions for many thyroid nodules.