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Massimiliano Andrioli Division of Endocrine and Metabolic Diseases, San Luca Hospital, Istituto Auxologico Italiano

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Chiara Carzaniga Division of Endocrine and Metabolic Diseases, San Luca Hospital, Istituto Auxologico Italiano

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Luca Persani Division of Endocrine and Metabolic Diseases, San Luca Hospital, Istituto Auxologico Italiano
Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Milan, Italy

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years [ 4 ]. Therefore, the correct identification of nodules that are malignant and avoidance of unnecessary procedures for those that are benign represent the challenge for endocrinologists. Cytological examination of material obtained by fine

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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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classification reporting US features in the transition age were selected. Inclusion criteria were (i) use of histology as a reference standard for the diagnosis of malignancy and histology or cytology as a reference standard for the diagnosis of benignity; (ii

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Renaud Ciappuccini Department of Nuclear Medicine and Thyroid Unit, François Baclesse Cancer Centre, Caen, France
INSERM 1086 ANTICIPE, Caen University, Caen, France

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Virginie Saguet-Rysanek Department of Pathology, François Baclesse Cancer Centre, Caen, France

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Marine Dorbeau Department of Pathology, François Baclesse Cancer Centre, Caen, France

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Justine Lequesne Department of Clinical Research, François Baclesse Cancer Centre, Caen, France

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Camille Linard Department of Pathology, François Baclesse Cancer Centre, Caen, France

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Sophie Lefevre-Arbogast Department of Clinical Research, François Baclesse Cancer Centre, Caen, France

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Bénédicte Clarisse Department of Clinical Research, François Baclesse Cancer Centre, Caen, France

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Stéphane Bardet Department of Nuclear Medicine and Thyroid Unit, François Baclesse Cancer Centre, Caen, France

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thyroid nodules with indeterminate cytology, enabling malignancy in 18 FCH-negative nodules to be reliably excluded ( 3 ). Some cases of increased and diffuse 18 FCH uptake in the thyroid gland have been described in the imaging workup of patients with

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Yasuhiro Ito Department of Surgery, Kuma Hospital, Shimoyamate-dori, Chuo-ku, Kobe, Hyogo, Japan

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Akira Miyauchi Department of Surgery, Kuma Hospital, Shimoyamate-dori, Chuo-ku, Kobe, Hyogo, Japan

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metastases and recurrences, PTC frequently metastasizes to regional lymph nodes, whereas distant metastasis/recurrence is predominant for FTC. PTC is generally diagnosed by cytological examination, whereas FTC is normally diagnosed on postoperative

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Roberto Negro Division of Endocrinology, V. Fazzi Hospital, Lecce, Italy

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Matteo Rucco United Technology Research Center, Trento, Italy

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Annalisa Creanza Division of Endocrinology and Metabolism, Mauriziano Hospital Umberto I, Turin, Italy

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Alberto Mormile Division of Endocrinology and Metabolism, Mauriziano Hospital Umberto I, Turin, Italy

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Paolo Piero Limone Division of Endocrinology and Metabolism, Mauriziano Hospital Umberto I, Turin, Italy

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Roberto Garberoglio Division of Endocrinology and Metabolism, Molinette Hospital, Turin, Italy

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Stefano Spiezia Endocrine Surgery, Ospedale del Mare, ASL NA1 Centro, Naples, Italy

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Salvatore Monti Endocrinology Unit, Azienda Ospedaliera Universitaria Sant’Andrea, Rome, Italy

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Christian Cugini Radiology Department, Villa Salus Hospital, Venice, Italy

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Ghassan El Dalati Radiology Department, Policlinico G.B. Rossi, Verona, Italy

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Maurilio Deandrea Division of Endocrinology and Metabolism, Mauriziano Hospital Umberto I, Turin, Italy

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patients with cytologically benign nodules subjected to RF at six Italian Institutions (benignity was confirmed by two repeated fine-needle aspirations, Class II of Bethesda reporting system). Data from 337 patients were obtained from a prospective study

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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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Else Marie Opsahl Section of Breast and Endocrine Surgery, Department of Oncology, Oslo University Hospital, Oslo, Norway
Institute of Clinical Medicine, University of Oslo, Oslo, Norway

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Lars Andreas Akslen Section for Pathology, Department of Clinical Medicine, Centre for Cancer Biomarkers CCBIO, University of Bergen, Bergen, Norway
Department of Pathology, Haukeland University Hospital Bergen, Bergen, Norway

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Ellen Schlichting Section of Breast and Endocrine Surgery, Department of Oncology, Oslo University Hospital, Oslo, Norway

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Turid Aas Department of Breast and Endocrine Surgery, Haukeland University Hospital, Bergen, Norway

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Katrin Brauckhoff Department of Breast and Endocrine Surgery, Haukeland University Hospital, Bergen, Norway

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Anne Irene Hagen Department of Breast and Endocrine Surgery, St. Olavs University Hospital, Trondheim, Norway

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Alf Frimann Rosenlund Section of Breast and Endocrine Surgery, Department of Surgery, University Hospital of North Norway, Tromsø, Norway

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Eva Sigstad Department of Pathology, Oslo University Hospital, Oslo, Norway

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Krystyna K. Grøholt Department of Pathology, Oslo University Hospital, Oslo, Norway

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Lovise Mæhle Department of Medical Genetics, Oslo University Hospital, Oslo, Norway

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Lars Fredrik Engebretsen Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
Department of Medical Genetics, St. Olavs University Hospital, Trondheim, Norway

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Lars H. Jørgensen Department of Thoracic Surgery, Oslo University Hospital, Oslo, Norway

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Jan Erik Varhaug Department of Clinical Science, University of Bergen, Bergen, Norway

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Trine Bjøro Institute of Clinical Medicine, University of Oslo, Oslo, Norway
Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway

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improved due to better sensitivity and increased use of biochemical, radiological, and cytological examinations, hence making MTC diagnosis possible at lower tumor stages [ 3 , 12 , 13 ]. Calcitonin is a good tumor marker in diagnostics and follow

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Pedro Marques Endocrinology Department, Instituto Português de Oncologia 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

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Maria João Bugalho 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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]. Moreover, US-guided fine-needle aspiration cytology is triggering an overdiagnosis of PTC, with the associated risks and harms of overtreatment [ 1 , 2 ]. It is estimated that 49% of the rising incidence of thyroid carcinomas consist of cancers measuring 1

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Rui Guo Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Province Key Laboratory of Hepatology Research, Guangzhou, Guangdong, People’s Republic of China

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Bowen Zheng Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Province Key Laboratory of Hepatology Research, Guangzhou, Guangdong, People’s Republic of China

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Tao Wu Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Province Key Laboratory of Hepatology Research, Guangzhou, Guangdong, People’s Republic of China

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Yufan Lian Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Province Key Laboratory of Hepatology Research, Guangzhou, Guangdong, People’s Republic of China

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Tinghui Yin Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Province Key Laboratory of Hepatology Research, Guangzhou, Guangdong, People’s Republic of China

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Yuting He Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Province Key Laboratory of Hepatology Research, Guangzhou, Guangdong, People’s Republic of China

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Jingya Qin Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Province Key Laboratory of Hepatology Research, Guangzhou, Guangdong, People’s Republic of China

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Zhicheng Yao Department of General Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Province Key Laboratory of Hepatology Research, Guangzhou, Guangdong, People’s Republic of China

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Wen Xu Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Province Key Laboratory of Hepatology Research, Guangzhou, Guangdong, People’s Republic of China

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Jie Ren Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Province Key Laboratory of Hepatology Research, Guangzhou, Guangdong, People’s Republic of China

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-defined dominant nodules ( Fig. 1A , blue nodule), which were confirmed as Bethesda class II on cytology, with a largest diameter ≥20 mm and/or complaining of cosmetic or symptomatic problems; and (v) refusal or unable to undergo thyroidectomy due to underlying

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Dorothée Bouron-Dal Soglio Department of Pathology, CHU Sainte-Justine, Montreal, Québec, Canada

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Leanne de Kock The Lady Davis Institute, Segal Cancer Centre, Jewish General Hospital, Montreal, Québec, Canada
Department of Human Genetics, McGill University, Montreal, Québec, Canada

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Richard Gauci Nuclear Medicine, Sir Charles Gairdner Hospital, Nedlands, Washington, Australia

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Nelly Sabbaghian The Lady Davis Institute, Segal Cancer Centre, Jewish General Hospital, Montreal, Québec, Canada

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Elizabeth Thomas Nuclear Medicine, Sir Charles Gairdner Hospital, Nedlands, Washington, Australia
Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Subiaco, Washington, Australia

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Helen C. Atkinson Faculty of Health and Medical Sciences, School of Medicine, The University of Western Australia, Crawley, Washington, Australia

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Nicholas Pachter Faculty of Health and Medical Sciences, School of Medicine, The University of Western Australia, Crawley, Washington, Australia
King Edward Memorial Hospital, Perth, Washington, Australia

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Simon Ryan Department of General Surgery, Sir Charles Gairdner Hospital, Nedlands, Washington, Australia

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John P. Walsh Faculty of Health and Medical Sciences, School of Medicine, The University of Western Australia, Crawley, Washington, Australia
Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Washington, Australia

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M. Priyanthi Kumarasinghe PathWest, QEII Medical Centre, Perth, Washington, Australia

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Karen Carpenter Department of Diagnostic Genomics, PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, Washington, Australia

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Ayça Aydoğan Department of Molecular Biology and Genetics, Bilkent University, Ankara, Turkey

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Colin J.R. Stewart King Edward Memorial Hospital, Perth, Washington, Australia

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William D. Foulkes The Lady Davis Institute, Segal Cancer Centre, Jewish General Hospital, Montreal, Québec, Canada
Department of Human Genetics, McGill University, Montreal, Québec, Canada
Department of Medical Genetics, Research Institute of the McGill University Health Centre, Montreal, Québec, Canada

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Catherine S. Choong Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Subiaco, Washington, Australia
Faculty of Health and Medical Sciences, School of Medicine, The University of Western Australia, Crawley, Washington, Australia

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). Ultrasound-guided fine needle aspiration (FNA) cytology revealed a follicular neoplasm and the patient underwent a right hemithyroidectomy in October 2007. Histopathological examination revealed 2 thyroid nodules (Fig 2 a, b). The first was a 35 mm

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