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Ana Isabel Álvarez-Mancha Department of Medicine, University of Malaga, Malaga, Spain
Department of Pathology, General University Hospital of Ciudad Real, Ciudad Real, Spain

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Isabel Mancha-Doblas Department of Medicine, University of Malaga, Malaga, Spain
Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain

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María Molina-Vega Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
The Biomedical Research Institute of Malaga and Platform in Nanomedicine (IBIMA-BIONAND Platform), University of Malaga, Malaga, Spain

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Diego Fernández-García Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain

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Ana María Gómez-Pérez Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
The Biomedical Research Institute of Malaga and Platform in Nanomedicine (IBIMA-BIONAND Platform), University of Malaga, Malaga, Spain

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Elena Gallego-Domínguez Department of Medicine, University of Malaga, Malaga, Spain
Department of Pathology, Virgen de la Victoria University Hospital, Málaga, Spain

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María Victoria Ortega-Jiménez Department of Medicine, University of Malaga, Malaga, Spain
Department of Pathology, Virgen de la Victoria University Hospital, Málaga, Spain

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Isabel Hierro-Martín Department of Pathology, Virgen de la Victoria University Hospital, Málaga, Spain

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Francisco J Tinahones Department of Medicine, University of Malaga, Malaga, Spain
Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
The Biomedical Research Institute of Malaga and Platform in Nanomedicine (IBIMA-BIONAND Platform), University of Malaga, Malaga, Spain

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, 6 , 7 , 8 , 9 ). A cytological diagnosis carries a certain risk of malignancy (ROM), which has implications for clinical recommendations. While FNA is an efficient and cost-effective diagnostic procedure, it is important to note that histological

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

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

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Murat Faik Erdogan Department of Endocrinology and Metabolism, University of Ankara School of Medicine, İbni Sina Hastanesi, Ankara, Turkey

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Cosimo Durante Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy

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Rose Ngu Head Neck and Thyroid Imaging, Department of Radiology, Guy’s and St Thomas’ Hospitals NHS Foundation Trust, London, United Kingdom

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Laurence Leenhardt Thyroid and Endocrine Tumors, Institute of Endocrinology, Pitié Salpêtrière Hospital, Pierre and Marie Curie University, Paris, France

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.8, 83.1, and 96.6%, respectively). Campanella et al. [ 10 ] reported similar findings, as the highest risk of malignancy was associated with a “taller-than-wide” shape (DOR of 10.2; 95% CI: 6.7–15.3), an absent halo sign (7.1; 95% CI: 3

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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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Aly Bernard Khalil Imperial College London Diabetes Center, Abu Dhabi, United Arab Emirates

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Roberto Dina Hammersmith Hospital, London, United Kingdom

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Karim Meeran Hammersmith Hospital, London, United Kingdom

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Ali M. Bakir Imperial College London Diabetes Center, Abu Dhabi, United Arab Emirates

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Saf Naqvi Imperial College London Diabetes Center, Abu Dhabi, United Arab Emirates

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Alia Al Tikritti Imperial College London Diabetes Center, Abu Dhabi, United Arab Emirates

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Nader Lessan Imperial College London Diabetes Center, Abu Dhabi, United Arab Emirates

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Maha T. Barakat Imperial College London Diabetes Center, Abu Dhabi, United Arab Emirates

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” diagnosis or Thy3 [ 8 , 9 ]. The reported risk of malignancy in this group is variable among different centers, ranging from 6 to 48% [ 10 ]. In this regard, the role of ultrasound has emerged as a practical and accurate tool in the risk stratification of

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Catherine Brophy Departments of Otolaryngology - Head and Neck Surgery, Cork, Ireland

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Rania Mehanna Departments of Otolaryngology - Head and Neck Surgery, Cork, Ireland

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Julie McCarthy Departments of Cytopathology, Cork University Hospital, Cork, Ireland

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Antoinette Tuthill Departments of Endocrinology, Cork University Hospital, Cork, Ireland

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Matthew S. Murphy Departments of Endocrinology, South Infirmary Victoria University Hospital, Cork, Ireland

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Patrick Sheahan Departments of Otolaryngology - Head and Neck Surgery, Cork, Ireland

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clinically apparent thyroid nodules is between 5 and 15% [ 2 ]. Fine-needle aspiration (FNA) cytology has demonstrated high utility in the diagnosis of thyroid nodules. In an effort to stratify thyroid nodules according to risk of malignancy in a consistent

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Signe Buhl Gram Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark

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Jacob Høygaard Rasmussen Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark

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Ulla Feldt-Rasmussen Department of Medical Endocrinology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark

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Jens Bentzen Department of Oncology, Herlev Hospital, Copenhagen University, Copenhagen, Denmark

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Giedrius Lelkaitis Department of Pathology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark

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Christian von Buchwald Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark

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Christoffer Holst Hahn Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark

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diagnosis [ 6 - 8 ]. Another diagnostic problem concerns patients with thyrotoxicosis or multinodular goitre without a cold nodule by scintigraphy, in which case FNA is not performed due to low risk of malignancy or because the patient will be referred to

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Gilles Russ Thyroid and Endocrine Tumor Unit, Department of Nuclear Medicine, Pitié Salpêtrière Hospital, University Pierre et Marie Curie, Paris, France

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Sophie Leboulleux Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy, University Paris-Sud, Villejuif, France

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Laurence Leenhardt Thyroid and Endocrine Tumor Unit, Department of Nuclear Medicine, Pitié Salpêtrière Hospital, University Pierre et Marie Curie, Paris, France

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

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between 1995 and 2005 increased more than threefold, and the number of MRIs more than doubled [ 13 ]. It follows, not surprisingly, that the number of FNAs has also increased correspondingly [ 13 ]. Risk of Malignancy according to the Way of

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Berna Evranos Ogmen Department of Endocrinology and Metabolism, Ankara Bilkent City Hospital, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey

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Cevdet Aydin Department of Endocrinology and Metabolism, Ankara Bilkent City Hospital, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey

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Ibrahim Kilinc Department of General Surgery, Ankara Bilkent City Hospital, Ankara, Turkey

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Aysegul Aksoy Altinboga Department of Pathology, Ankara Bilkent City Hospital, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey

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Reyhan Ersoy Department of Endocrinology and Metabolism, Ankara Bilkent City Hospital, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey

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Bekir Cakir Department of Endocrinology and Metabolism, Ankara Bilkent City Hospital, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey

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biopsy should be accorded greater or lesser weight than the index AUS/FLUS diagnosis. The risk for malignancy of a nodule of initial AUS/FLUS status followed by benign status may lie somewhere between the risks of malignancy for the 2 individual

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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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Bülent Öcal Department of Otolaryngology, Ministry of Health Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey

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Mehmet Hakan Korkmaz Department of Otolaryngology, Yıldırım Beyazıt University Medical School, Ankara, Turkey

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Demet Yılmazer Department of Pathology, Ministry of Health Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey

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Tuğba Taşkın Türkmenoğlu Department of Pathology, Ministry of Health Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey

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Ömer Bayır Department of Otolaryngology, Ministry of Health Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey

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Güleser Saylam Department of Otolaryngology, Ministry of Health Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey

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Emel Çadallı Tatar Department of Otolaryngology, Ministry of Health Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey

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Sevilay Karahan Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey

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Erman Çakal Department of Endocrinology, Ministry of Health Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey

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recommendations emphasized that each institution should independently define the risk of malignancy in each of the indeterminate cytology categories of the Bethesda System for Reporting Thyroid Cytopathology to guide clinicians and surgeons in choosing an

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