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Andrea Leoncini Clinic for Radiology, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland

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Chiara Camponovo Thyroid Unit, Clinic for Endocrinology and Diabetology, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland

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Gaetano Paone Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland

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Elena Gamarra Thyroid Unit, Clinic for Endocrinology and Diabetology, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland

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Giorgio Treglia Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland
Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland

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Pierpaolo Trimboli Thyroid Unit, Clinic for Endocrinology and Diabetology, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland

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ultrasound reports. They also aim to improve the indication of fine-needle aspiration cytology (FNAC) by evaluating TNs based on category-risk assessment and category-specific dimensional cut-offs. Although the different TIRADS were developed with varying

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Tamas Solymosi Endocrinology and Metabolism Clinic, Bugat Hospital, Gyöngyös, Hungary
Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

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

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Steen J Bonnema Department of Endocrinology, Odense University Hospital, Odense, Denmark

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Andrea Frasoldati Endocrinology Unit of Arcispedale S Maria Nuova, Reggio Emilia, Italy

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Laszlo Jambor Department of Radiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

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Zsolt Karanyi Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

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Gabor L Kovacs 1st Department of Medicine, Flohr Ferenc Hospital, Kistarcsa, Hungary

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Enrico Papini Regina Apostolorum Hospital in Albano, Rome, Italy

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Karoly Rucz 1st Department of Medicine, University of Pecs, Pecs, Hungary

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Gilles Russ Unité Thyroïde et Tumeurs Endocrines – Pr Leenhardt Hôpital La Pitie Salpetriere, Sorbonne Université, Paris, France

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Endre V Nagy Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

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Introduction For more than three decades, the cornerstones in the clinical management of patients with thyroid nodules have been ultrasound (US) and fine-needle aspiration cytology (FNA) ( 1 , 2 , 3 ). Robust evidence demonstrates that the

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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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.7%), Bethesda III ( n  = 16; 34%), Bethesda IV ( n  = 8; 17%), and Bethesda V ( n  = 1; 2.1%) ( Fig. 4 ). Figure 4 Cytological evaluation by fine needle aspiration (FNA) of 46 autonomously functioning thyroid nodules (AFTN). Bethesda categories II, III

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Antonis Polymeris Department of Endocrinology, Metabolism and Diabetes Mellitus/Sismanogleio-Amalia Fleming Hospital, Athens, Greece

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Christina Kogia Department of Endocrinology, Metabolism and Diabetes Mellitus/Sismanogleio-Amalia Fleming Hospital, Athens, Greece

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Dimitrios Ioannidis Department of Endocrinology, Metabolism and Diabetes Mellitus/Sismanogleio-Amalia Fleming Hospital, Athens, Greece

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Dimitrios Lilis Department of Endocrinology, Metabolism and Diabetes Mellitus/Sismanogleio-Amalia Fleming Hospital, Athens, Greece

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Maria Drakou Department of Endocrinology, Metabolism and Diabetes Mellitus/Sismanogleio-Amalia Fleming Hospital, Athens, Greece

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Nicoletta Maounis Department of Cytology/Sismanogleio-Amalia Fleming Hospital, Athens, Greece

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Loukas Kaklamanis Department of Pathology/Mediterraneo Hospital, Glyfada, Greece

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Sofia Tseleni-Balafouta First Department of Pathology/University of Athens, Medical School, Athens, Greece

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composition with calcifications occupying the right lobe. Thyroid function tests revealed low T3 (apparently within the context of low T3 syndrome) and positive anti-thyroglobulin antibodies. We performed fine-needle aspiration of the thyroid lesion that

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Sara Donato Endocrinology Department, Instituto Português de Oncologia de Lisboa, Lisbon, Portugal

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Helder Simões Endocrinology Department, Instituto Português de Oncologia de Lisboa, Lisbon, Portugal
NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal

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Valeriano Leite Endocrinology Department, Instituto Português de Oncologia de Lisboa, Lisbon, Portugal
NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
Unidade de Investigação em Patobiologia Molecular, Instituto Português de Oncologia de Lisboa, Lisbon, Portugal

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nodule in the thyroid gland was disclosed. The US identified a solid isocogenic nodule of 17 × 18 × 8 mm, EU-TIRADS 3 [ 9 ], and the US-guided fine-needle aspiration biopsy diagnosis was suspicious for malignancy (Bethesda V [ 10 ]). She was then

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Kanhaiyalal Agrawal Departments of Nuclear Medicine, London, UK

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James Weaver Departments of King's College London, London, UK

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Fahim Ul-Hassan Departments of Nuclear Medicine, London, UK
Departments of Clinical PET Centre, King's College London, London, UK

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Jean-Pierre Jeannon Departments of Otorhinolaryngology Head and Neck Surgery, London, UK

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Ricard Simo Departments of Otorhinolaryngology Head and Neck Surgery, London, UK

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Paul Carroll Departments of Consultant Endocrinologist, London, UK

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Johnathan G. Hubbard Departments of Consultant Endocrine Surgeon, Guy's and St Thomas' NHS Foundation Trust, London, UK

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Ashish Chandra Departments of Histopathology/Cytology, London, UK

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Hosahalli Krishnamurthy Mohan Departments of Nuclear Medicine, London, UK
Departments of Clinical PET Centre, King's College London, London, UK

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uptake with ultrasonography (USG) with and without fine-needle aspiration (FNA) and where appropriate referral to the head and neck, endocrinology or endocrine surgery teams for further management. The final diagnosis for the focal thyroid incidentalomas

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X Y Hu Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

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J Wu Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

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P Seal EFW Radiology, Calgary, Alberta, Canada

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S A Ghaznavi Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
Department of Medicine, Section of Endocrinology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

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C Symonds Department of Medicine, Section of Endocrinology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

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S Kinnear Department of Medicine, Section of Endocrinology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

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R Paschke Department of Medicine, Section of Endocrinology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
Departments of Medicine, Oncology, Pathology and Laboratory Medicine, Biochemistry and Molecular Biology, and Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

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malignancy risk stratification information, in addition to patient characteristics, clinicians make a decision between pursuing further diagnostic testing (usually in the form of fine-needle aspiration biopsy (FNAB)), repeating ultrasound imaging, or

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Fabio Maino Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy

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Cristina Dalmiglio Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy

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Nicoletta Benenati Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy

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Michele Campanile Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy

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Tania Pilli Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy

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Raffaella Forleo Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy

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Lucia Brilli Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy

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Cristina Ciuoli Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy

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Silvia Cantara Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy

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Marco Capezzone Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy

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Alessandra Cartocci Department of Medical Biotechnologies, University of Siena, Siena, Italy

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Furio Pacini Humanitas Clinical Institute, Humanitas University, Rozzano, Italy

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Maria Grazia Castagna Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy

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thyroid nodular disease who underwent fine-needle aspiration cytology (FNAC) with adequate cytology from 2003 to 2019. Exclusion criteria were (1) patients with a family history of MTC or MEN syndrome; (2) patients with known presence of kidney failure

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Roussanka D. Kovatcheva Department of Endocrinology, Medical University of Sofia, Sofia, Bulgaria

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Alexander D. Shinkov Department of Endocrinology, Medical University of Sofia, Sofia, Bulgaria

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Inna D. Dimitrova Department of Endocrinology, Medical University of Sofia, Sofia, Bulgaria

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Ralitsa B. Ivanova Department of Endocrinology, Medical University of Sofia, Sofia, Bulgaria

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Kalin N. Vidinov Department of Endocrinology, Medical University of Sofia, Sofia, Bulgaria

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Radina S. Ivanova Department of Endocrinology, Medical University of Sofia, Sofia, Bulgaria

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to discriminate benign from malignant nodules, since cancer prevalence is 7–15% of all nodules [ 2 ]. US-guided fine-needle aspiration biopsy (FNAB) with cytology has high sensitivity and specificity in differentiating benign from malignant nodules

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Ernesto Maddaloni Endocrinology and Diabetes Unit, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy

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Silvia Irina Briganti Endocrinology and Diabetes Unit, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy

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Anna Crescenzi Pathology Unit, Campus Bio-Medico University of Rome, Rome, Italy

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Giuseppina Beretta Anguissola Endocrinology and Diabetes Unit, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy

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Eleonora Perrella Pathology Unit, Campus Bio-Medico University of Rome, Rome, Italy

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Chiara Taffon Pathology Unit, Campus Bio-Medico University of Rome, Rome, Italy

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Andrea Palermo Endocrinology and Diabetes Unit, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy

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Silvia Manfrini Endocrinology and Diabetes Unit, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy

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Paolo Pozzilli Endocrinology and Diabetes Unit, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy

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Angelo Lauria Pantano Endocrinology and Diabetes Unit, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy

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. Thyroid ultrasound (US) examination represents the gold standard for the stratification of thyroid lesions, determining the need for fine-needle aspiration (FNA). An improper use of FNA has the risk of increasing healthcare expenditures and even of

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