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Alessia Cozzolino Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy

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Tiziana Filardi Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy

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Ilaria Simonelli Service of Medical Statistics and Information Technology, Fatebenefratelli Foundation for Health Research and Education, Rome, Italy
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

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Giorgio Grani Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy

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Camilla Virili Endocrinology Unit, Department of Medico-Surgical Sciences and Biotechnologies, ‘Sapienza’ University of Rome, Latina, Italy

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Ilaria Stramazzo Endocrinology Unit, Department of Medico-Surgical Sciences and Biotechnologies, ‘Sapienza’ University of Rome, Latina, Italy

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Maria Giulia Santaguida Endocrinology Unit, Department of Medico-Surgical Sciences and Biotechnologies, ‘Sapienza’ University of Rome, Latina, Italy

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Pietro Locantore Endocrinology Unit, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy

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Massimo Maurici Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

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Daniele Gianfrilli Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy

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Andrea M Isidori Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy

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Cosimo Durante Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy

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Carlotta Pozza Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy

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on behalf of TALENT Group
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on behalf of TALENT Group

observational studies, mostly retrospective, have been conducted to identify the US features associated with the risk of malignancy in pediatric thyroid nodules. In 2016, they have been summarized in a meta-analysis reporting that the presence of internal

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Kassia B. Reuters Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil

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Maria C.O.C. Mamone Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil

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Elsa S. Ikejiri Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil

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Cleber P. Camacho Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil

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Claudia C.D. Nakabashi Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil

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Carolina C.P.S. Janovsky Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil

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Ji H. Yang Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil

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Danielle M. Andreoni Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil

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Rosalia Padovani Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
Santa Casa de São Paulo, São Paulo, Brazil

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Rui M.B. Maciel Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
Fleury Medicina e Saúde, São Paulo, Brazil

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Felipe A.B. Vanderlei Head and Neck Division, Department of Otorhinolaryngology and Head and Neck Surgery, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil

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Rosa P.M. Biscolla Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
Fleury Medicina e Saúde, São Paulo, Brazil

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(< 10 mm in diameter) [ 8 - 10 ]. Some sonographic features, such as hypoechogenicity, the presence of microcalcifications, irregular margins, and a taller than wide shape, are used to evaluate the risk of malignancy, but these findings alone cannot be

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M Grussendorf Department of Internal Medicine, University Hospital, Düsseldorf, Germany

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I Ruschenburg MVZ Wagnerstibbe Center for Cytology and Pathology, Einbeck, Germany

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G Brabant Department of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, University of Manchester, Manchester, UK

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age, only the risk of young patients under 30 years of age appears to be increased (ROM: 2.8%; see Table 3 ). Table 4 relates ROM to the presenting thyroid disorder. Table 2 Histological findings in patients with thyroid malignancies in

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Irini S. Hadjisavva Economides Nicosia Endocrinology Center, Nicosia, Cyprus

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Roberto Dina Department of Cellular Pathology, Hammersmith Hospital, Imperial College Healthcare Trust, London, UK

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Michael A. Talias Healthcare Management Postgraduate Program, Open University of Cyprus, Nicosia, Cyprus

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Panayiotis A. Economides Economides Nicosia Endocrinology Center, Nicosia, Cyprus

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14.3%. In the literature, the reported risk of malignancy ranges between 5 and 15% [ 1 , 3 , 4 , 20 ]. However, in contrast to our cohort, in previous studies using the same methodology, either only nodules above 10 mm were subjected to FNA (cancer

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Francesco Boi Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy

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Fabiana Pani Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy

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Stefano Mariotti Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy

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with HT. Table 2. Thyroid autoimmunity and thyroid cancer: risk factors for malignancy identified in recent large retrospective FNAC studies In the first of these studies, Boi et al. [ 10 ] in 2005 retrospectively described a higher

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Maria Rossing Department of Endocrinology, Herlev University Hospital, Herlev
Center of Genomic Medicine, Rigshospitalet, Copenhagen University, Copenhagen, Denmark

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Birte Nygaard Department of Endocrinology, Herlev University Hospital, Herlev

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Finn Cilius Nielsen Center of Genomic Medicine, Rigshospitalet, Copenhagen University, Copenhagen, Denmark

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Finn Noe Bennedbæk Department of Endocrinology, Herlev University Hospital, Herlev

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habits) were listed prospectively. Sonographic features of the neck US were registered including detailing number and position of the nodule(s), size, shape, margins, content, and vascularity focusing on risk stratification for nodule malignancy

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Cosimo Durante Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy

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Laszlo Hegedüs Department of Endocrinology, Odense University Hospital, Odense, Denmark

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Agnieszka Czarniecka M. Sklodowska-Curie National Research, Institute of Oncology Gliwice Branch, Gliwice, Poland

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Ralf Paschke Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

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Gilles Russ Thyroid and Endocrine Tumors Department, Pitié-Salpêtrière Hospital, Sorbonne University GRC N°16, Paris, France

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Fernando Schmitt Faculty of Medicine of University of Porto, CINTESIS@RISE and Institute of Molecular Pathology and Immunology, University of Porto (Ipatimup), Porto, Portugal

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Paula Soares Institute of Investigation and Innovation in Health (I3S), Faculty of Medicine of the University of Porto, Porto, Portugal

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Tamas Solymosi Endocrinology and Metabolism Clinic, Bugat Hospital, Gyöngyös, Hungary

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Enrico Papini Department of Endocrine and Metabolic Diseases, Regina Apostolorum Hospital, Albano, Rome, Italy

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largest diameter over 5 years: 4.9 mm (95% CI, 4.2–5.5 mm)) ( 106 ), changes in TIRADS category which qualify for further workup (rate of change over 5 years: 6.3–8.3%) ( 126 ), risk of overlooking malignancy over the next 5 years (rate: 0.6%) ( 106 ), we

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L. Leenhardt Department of Nuclear Medicine, Pitié Salpêtrière Hospital, Cancer Institute, Pierre et Marie Curie University, Paris, France

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M.F. Erdogan Department of Endocrinology and Metabolism, University of Ankara School of Medicine, İbni Sina Hastanesi, Ankara, Turkey

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L. Hegedus Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark

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S.J. Mandel Division of Endocrinology, Diabetes and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa., USA

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R. Paschke Department of Endocrinology, University of Leipzig, Leipzig, Germany

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T. Rago Endocrine Unit 1, Department of Internal Medicine, Ospedale Cisanello, University of Pisa, Pisa, Italy

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G. Russ Department of Nuclear Medicine, Pitié Salpêtrière Hospital, Cancer Institute, Pierre et Marie Curie University, Paris, France

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DM, Ramirez M, Lee TM, Irvin GL 3rd: Surgeon-performed ultrasound in the management of thyroid malignancy. Am Surg 2004;70:576-580. 15279178 48 do Rosario PW, Borges MA, Alves MF, Purisch S, Padrao EL, Rezende LL, Barroso AL: Follow-up of high-risk

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Giorgio Grani Department of Translational and Precision Medicine, “Sapienza” University of Rome, Rome, Italy

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Livia Lamartina Department of Translational and Precision Medicine, “Sapienza” University of Rome, Rome, Italy

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Valeria Ramundo Department of Translational and Precision Medicine, “Sapienza” University of Rome, Rome, Italy

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Rosa Falcone Department of Translational and Precision Medicine, “Sapienza” University of Rome, Rome, Italy

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Cristiano Lomonaco Department of Translational and Precision Medicine, “Sapienza” University of Rome, Rome, Italy

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Laura Ciotti Department of Translational and Precision Medicine, “Sapienza” University of Rome, Rome, Italy

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Martina Barone Department of Translational and Precision Medicine, “Sapienza” University of Rome, Rome, Italy

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Marianna Maranghi Department of Translational and Precision Medicine, “Sapienza” University of Rome, Rome, Italy

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Vito Cantisani Diagnostic and Ultrasound Innovations Unit, Azienda Ospedaliera Universitaria Policlinico Umberto I, “Sapienza” University of Rome, Rome, Italy

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Sebastiano Filetti Department of Translational and Precision Medicine, “Sapienza” University of Rome, Rome, Italy

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Cosimo Durante Department of Translational and Precision Medicine, “Sapienza” University of Rome, Rome, Italy

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ratio threshold for TTW nodules might improve the specificity of risk stratification systems in ruling out malignancy and, in particular, in pinpointing nodules for which FNAC can safely be deferred. The study described below was undertaken to explore

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Aglaia Kyrilli Department of Endocrinology, Hôpital Universitaire de Bruxelles (H.U.B.)– Hôpital Erasme, Université Libre de Bruxelles (ULB), Route de Lennik 808, Brussels, Belgium

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Nunzia Tacelli Department of Radiology, Hôpital Universitaire de Bruxelles (H.U.B.)– Hôpital Erasme, Université Libre de Bruxelles (ULB), Route de Lennik 808, Brussels, Belgium

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Lucia Russo Department of Medicine, DIMED, Internal Medicine 3, University of Padua, Via Giustiniani 2, 35128, Padova, Italy

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Laetitia Lebrun Department of Pathology, Hôpital Universitaire de Bruxelles (H.U.B.)– Hôpital Erasme, Université Libre de Bruxelles (ULB), Route de Lennik 808, Brussels, Belgium

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Isabelle Salmon Department of Pathology, Hôpital Universitaire de Bruxelles (H.U.B.)– Hôpital Erasme, Université Libre de Bruxelles (ULB), Route de Lennik 808, Brussels, Belgium

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Gilles Russ Thyroid and Endocrine Tumors, Institute of Endocrinology, Pitié Salpêtrière Hospital, Pierre et Marie Curie University, Paris, France

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Rodrigo Moreno-Reyes Department of Nuclear Medicine, Hôpital Universitaire de Bruxelles (H.U.B.)– Hôpital Erasme, Université Libre de Bruxelles (ULB), Route de Lennik, Brussels, Belgium

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Bernard Corvilain Department of Endocrinology, Hôpital Universitaire de Bruxelles (H.U.B.)– Hôpital Erasme, Université Libre de Bruxelles (ULB), Route de Lennik 808, Brussels, Belgium

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(US), the first-line tool to stratify malignancy risk of thyroid nodules, does not, unlike scintigraphy, evaluate the nodule’s functional characteristics. The utility to effectively diagnose AFTN relies on the generally admitted assumption that AFTN

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