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W J Bom Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands

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F B M Joosten Department of Radiology, Rijnstate Hospital, Arnhem, the Netherlands

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M M G J van Borren Department of Clinical Chemistry, Rijnstate Hospital, Arnhem, the Netherlands

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E P Bom Department of Radiology, Rijnstate Hospital, Arnhem, the Netherlands

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R R J P van Eekeren Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands

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H de Boer Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands

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Introduction About 10% of the population has a benign non-functioning thyroid nodule (NFTN) of 1 cm or larger ( 1 ), and 4–7% of these nodules are symptomatic ( 2 , 3 , 4 ). Unilateral lobectomy and volume reduction by radioiodine (RAI) have

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Yuerong Yan Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China

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Lili You Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China

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Xiaoyi Wang Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China

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Zhuo Zhang Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China

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Feng Li Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China

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Hongshi Wu Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China

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Muchao Wu Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China

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Jin Zhang Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China

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Jiayun Wu Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China

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Caixia Chen Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China

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Xiaohui Li Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China

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Biwen Xia Department of Endocrinology, The Fourth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China

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Mingtong Xu Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China

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Li Yan Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China

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contrast to the large decline in thyroid goiter, thyroid nodules have become increasingly common in mainland China, increasing from 2.73% in 1999 to 12.8% in 2011 and then to 20.43% in 2015 ( 10 , 11 ). The marked increase in thyroid nodules may be largely

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Jiali Tian Ultrasound Department, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China

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Jinlei Liang Ultrasound Department, Zhuhai People's Hospital, Zhuhai, China

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Yuhong Lin Ultrasound Department, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China

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Liping Wang Ultrasound Department, Zhuhai Xiangzhou District People's Hospital, Zhuhai, China

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Xiaobo Chen Ultrasound Department, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China

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Introduction Thyroid nodules (TNs) are common endocrine masses that can be detected by palpation in approximately 4–7% of cases; however, ultrasound (US) examination of the thyroid is ten times more sensitive than palpation and can detect 19

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Lei Hu Department of Ultrasound, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China

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Xiao Liu Department of Ultrasound, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China

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Chong Pei Department of Respiratory and Critical Care Medicine, The First People’s Hospital of Hefei City, The Third Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China

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Li Xie Department of Ultrasound, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China

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Nianan He Department of Ultrasound, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China

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Introduction Thyroid nodules (TNs) are a common endocrine disease in China ( 1 , 2 , 3 ). It is estimated that 7–15% of TNs are thyroid cancer. Ultrasound (US) is useful not only for detection but also for discrimination between benign and

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Irfan Vardarli 5th Medical Department, Division of Endocrinology and Diabetes, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

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Susanne Tan Department of Endocrinology, Diabetes and Metabolism, Clinical Chemistry – Division of Laboratory Research Endocrine Tumor Center at WTZ/Comprehensive Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Rainer Görges Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Bernhard K Krämer 5th Medical Department, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

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Ken Herrmann Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Christoph Brochhausen Institue of Pathology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

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Introduction The most common endocrine cancer is thyroid carcinoma, which accounts for approximately 1.0–1.5% of all newly diagnosed cancers each year in the USA ( 1 ). Only approximately 10–15% of thyroid nodules, which are common, are

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Luchuan Li Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China

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Baoyuan Li Department of Thyroid Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China

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Bin Lv Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China

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Weili Liang Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China

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Binbin Zhang Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China

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Qingdong Zeng Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China

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Andrew G Turner Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia

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Lei Sheng Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China

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). Some studies have also reported an increased risk of malignancies, including hematopoietic, breast, skin, thyroid, and urinary tract carcinoma ( 5 , 6 , 7 ). Previous studies have reported 15–75% of patients with PHPT have concomitant thyroid nodules

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Kristine Zøylner Swan Department of Otorhinolaryngology Head & Neck Surgery, Aarhus University Hospital, Aarhus N, Denmark
Department of Clinical Medicine, Health, Aarhus University, Aarhus N, Denmark

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Steen Joop Bonnema Department of Endocrinology, Odense University Hospital, Odense C, Denmark

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Marie Louise Jespersen Department of Pathology, Aarhus University Hospital, Aarhus N, Denmark

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Viveque Egsgaard Nielsen Department of Clinical Medicine, Health, Aarhus University, Aarhus N, Denmark

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Introduction Thyroid nodular disease is common in many populations, with the majority of the nodules being benign ( 1 ). The primary purpose of diagnostic testing is to assess the risk of thyroid carcinoma in these nodules. Although

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Caroline Y Hayashi Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University (Unesp), Botucatu, São Paulo, Brazil

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Danilo T A Jaune Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University (Unesp), Botucatu, São Paulo, Brazil

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Cristiano C Oliveira Department of Pathology, Botucatu Medical School, Sao Paulo State University (Unesp), Botucatu, São Paulo, Brazil

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Bárbara P Coelho Department of Surgery and Orthopedics, Botucatu Medical School, Sao Paulo State University (Unesp), Botucatu, São Paulo, Brazil

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Hélio A Miot Department of Dermatology, Botucatu Medical School, Sao Paulo State University (Unesp), Botucatu, São Paulo, Brazil

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Mariângela E A Marques Department of Pathology, Botucatu Medical School, Sao Paulo State University (Unesp), Botucatu, São Paulo, Brazil

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José Vicente Tagliarini Department of Otolaryngology and Head and Neck Surgery, Botucatu Medical School, Sao Paulo State University (Unesp), Botucatu, São Paulo, Brazil

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Emanuel C Castilho Department of Otolaryngology and Head and Neck Surgery, Botucatu Medical School, Sao Paulo State University (Unesp), Botucatu, São Paulo, Brazil

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Carlos S P Soares Department of Otolaryngology and Head and Neck Surgery, Botucatu Medical School, Sao Paulo State University (Unesp), Botucatu, São Paulo, Brazil

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Flávia R K Oliveira Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University (Unesp), Botucatu, São Paulo, Brazil

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Paula Soares Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal
Cancer Signaling and Metabolism Group, Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal
Department of Pathology, Medical Faculty of the University of Porto, Porto, Portugal

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Gláucia M F S Mazeto Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University (Unesp), Botucatu, São Paulo, Brazil

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81% for AUS/FLUS and 11 and 65.7% for FN/SFN nodules have been reported ( 4 ). Thus, studies using techniques with varying degrees of complexity and cost have been conducted to clarify the nature of AUS/FLUS and FN/SFN thyroid lesions, such as those

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Xiaoya Zheng Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China

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Heng Xiao Department of Hepatobiliary Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China

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Jian Long Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China

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Qiang Wei Prevention of Disease Department, Chongqing Jiulongpo District Hospital of Traditional Chinese Medicine, Chongqing, China

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Liping Liu Department of Ultrasound, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China

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Liping Zan Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China

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Wei Ren Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China

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nodules ( 9 ). It has been reported that internal echogenicity is lower and irregular after the development of thyroid dysfunction induced by PD-1 antibody therapy ( 10 ). Another study found that hypoechogenicity on thyroid sonography was associated with

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Giorgio Grani Department of Internal Medicine and Medical Specialties, ‘Sapienza’ University of Rome, Rome, Italy

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Livia Lamartina Department of Internal Medicine and Medical Specialties, ‘Sapienza’ University of Rome, Rome, Italy

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Vito Cantisani UOS Innovazioni Diagnostiche e Ultrasonografiche, Azienda Ospedaliera Universitaria Policlinico Umberto I, ‘Sapienza’ University of Rome, Rome, Italy

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Marianna Maranghi Department of Internal Medicine and Medical Specialties, ‘Sapienza’ University of Rome, Rome, Italy

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Piernatale Lucia Department of Internal Medicine and Medical Specialties, ‘Sapienza’ University of Rome, Rome, Italy

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

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Introduction Thyroid nodules are an increasingly common finding during imaging examinations of the neck, but only a small proportion of these lesions ultimately prove to be malignant ( 1 ). Fine-needle aspiration (FNA) biopsy plays a major

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