Thyroid最新文献

{"title":"Progastrin-Releasing Peptide and Procalcitonin as Additional Markers in the Diagnostic Workup for Medullary Thyroid Carcinoma.","authors":"Leonoor E Schonebaum, Sjoerd A A van den Berg, Mathé van Balkum, W Edward Visser, Luca Giovanella, Robin P Peeters","doi":"10.1089/thy.2024.0293","DOIUrl":"https://doi.org/10.1089/thy.2024.0293","url":null,"abstract":"<p><p><b><i>Background:</i></b> Calcitonin (CT), a well-established tumor marker for medullary thyroid carcinoma (MTC), is limited by a high rate of false positives in the diagnostic phase. Potential new markers for MTC are procalcitonin (PCT) and progastrin-releasing peptide (proGRP). Where literature has proven noninferiority for PCT, evidence is lacking for proGRP. Therefore, the present study prospectively evaluated the clinical performance of proGRP and PCT in a multicohort study of patients with MTC compared with other thyroid diseases. <b><i>Methods:</i></b> Adult patients undergoing thyroid surgery for thyroid nodular disease diagnosed in a tertiary center from the Netherlands (discovery cohort) between 2013 and 2025 were prospectively included. Serum samples were collected preoperatively. Diagnostic performance of CT, PCT, proGRP, and carcinoembryonic antigen was calculated separately. A two-step approach, combining different markers, was investigated. Analyses were repeated in a validation cohort from Switzerland. <b><i>Results:</i></b> The discovery and validation cohorts consisted of 335 and 61 patients, respectively. Patients had benign disease (<i>n</i> = 166), other thyroid carcinomas (non-MTC, <i>n</i> = 186), or MTC (<i>n</i> = 44). Median proGRP and PCT levels were significantly higher in MTC compared with benign disease and non-MTC. ProGRP had a low sensitivity (69.2% [CI 48.2-85.7]), while PCT performed similarly to CT (100.0% [CI 89.1-100.0] and 100.0% [CI 88.8-100.0], respectively). The combination of CT and PCT, both in the individual cohorts and when combining the two cohorts, showed the best diagnostic performance with a sensitivity of 100% [CI 91.8-100.0] and negative predictive value of 100% [CI 98.9-100.0] and specificity and positive predictive value of 99.7% [CI 98.4-100.0] and 97.7% [CI 88.0-99.9], respectively. <b><i>Conclusions:</i></b> ProGRP alone or with CT does not have additional value as a diagnostic marker for MTC. A two-step approach combining the use of CT and PCT measurement, in the CT concentration range between 10 and 100 pg/mL, is a promising method to diagnose MTC in patients with thyroid nodules with high diagnostic accuracy.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing Thyroid Hormone Replacement, Baseline Thyrotropin, and Survival in Immune Checkpoint Inhibitor-Associated Thyroid Dysfunction.","authors":"Duaa Abdallah, Jake Johnson, Fang Qiu, Whitney Goldner, Apar Kishor Ganti, Anupam Kotwal","doi":"10.1089/thy.2025.0076","DOIUrl":"https://doi.org/10.1089/thy.2025.0076","url":null,"abstract":"<p><p><b><i>Background:</i></b> Thyroid dysfunction (TD) occurs commonly from immune checkpoint inhibitors (ICI) cancer therapy, but questions remain regarding its predicting factors, appropriate dosing for thyroid hormone replacement, and the strength of association with overall survival (OS). We aim to address these three questions in our study. <b><i>Methods:</i></b> We performed a retrospective cohort study of adult patients with cancer who received ICIs from December 1, 2012, to December 31, 2019. After excluding 28 patients with preexisting primary hypothyroidism, 811 patients were evaluated for the development of new-onset ICI-TD. Kaplan-Meier survival and log-rank tests were used to compare OS distributions between ICI-TD status groups, following which Cox regression models addressed immortal time bias (ITB). <b><i>Results:</i></b> Of the 811 included patients with a median follow-up of 19.2 months, 122 (15.0%) patients developed ICI-TD. The median age at initiation of ICIs was 64.8 years; women comprised 42.8% of the cohort. There were no significant differences in age, sex, race, malignancy type, or personal history of autoimmunity in patients who developed ICI-TD versus those who did not. ICI-TD occurred most frequently after combination ICI therapy (32%) compared with CTLA-4 ICI and PD-1/PD-L1 ICI monotherapy (<i>p</i> = 0.002). The median levothyroxine dose was the highest, being 1.41 mcg/kg/day in the overt hypothyroidism group. Patients with ICI-TD had a higher median pre-treatment log2(thyrotropin or TSH) level (1.2, corresponding to TSH 2.3 mIU/L) versus those without (0.79, corresponding to TSH 1.7 mIU/L; <i>p</i> = 0.008); however, the area under the curve was <0.6, hence lacking predictive ability. The survival benefit of ICI-TD was not apparent after addressing ITB and adjusting for other variables affecting patient outcomes. <b><i>Conclusions:</i></b> The levothyroxine dose needed for overt hypothyroidism from ICI-TD is similar to athyreotic hypothyroidism. While baseline TSH in the upper normal range is associated with an increased risk of ICI-TD, there is no absolute baseline TSH value that accurately predicts ICI-TD in the clinical setting. The link between ICI-TD and OS needs further validation after accounting for ITB.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When the Slide Knows the Sequence: Artificial Intelligence-Assisted Pathology Predicts Mutations in Thyroid Cancer.","authors":"Carl Christofer Juhlin","doi":"10.1089/thy.2025.0335","DOIUrl":"https://doi.org/10.1089/thy.2025.0335","url":null,"abstract":"","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cigarette Smoking Drives Thyroid Eye Disease Progression via RAGE Signaling Activation.","authors":"Jin Liu, Tianyi Zhu, Li Yang, Weijin Qian, Lianfei Fang, Weiqi Zhang, Haiyang Zhang, Yi Wang, Baiguang Yu, Jing Sun, Bin Li, Dan Li, Yinwei Li, Sijie Fang, Huifang Zhou","doi":"10.1089/thy.2025.0062","DOIUrl":"https://doi.org/10.1089/thy.2025.0062","url":null,"abstract":"<p><p><b><i>Background:</i></b> Thyroid eye disease (TED) is a sight-threatening autoimmune disease with cigarette smoking as one of the key risk factors. Cigarette smoking affects both the severity of TED and the patient's response to medication. However, the underlying pathogenic mechanisms of smoking in TED remain unclear. <b><i>Methods:</i></b> Orbital fibroblasts (OFs) were extracted from patients with TED and non-TED controls, and treated with cigarette smoking extract (CSE). Luminex assays and Western blots were employed to examine inflammatory status and pathological phenotypes of OFs. A specific reactive oxygen species (ROS) probe was used to evaluate oxidative stress levels. RNA-sequencing of CSE-treated OFs was used to analyze differentially expressed genes. Immunofluorescence and RNA-sequencing were used to examine the expression of receptor for advanced glycation end products (RAGE) signaling molecules in patients. Small interfering RNA sequences and a RAGE-specific inhibitor were employed to investigate the effects of RAGE blockade on cigarette smoking-related pathological phenotypes. To validate our findings <i>in vivo</i>, we generated an adenovirus-induced TED mouse model with exposure to cigarette smoke. <b><i>Results:</i></b> Exposure to CSE resulted in an inflammatory phenotype of OFs together with higher levels of oxidative stress. OFs exposed to CSE presented susceptibility to transforming growth factor-β-induced myofibroblast differentiation, and 15-D-PGJ₂-induced adipocyte differentiation, indicating pro-fibrotic and pro-adipogenic phenotypes. RNA-sequencing of CSE-treated OFs revealed upregulation of RAGE signaling molecules. TED patients with smoking history also exhibited higher levels of RAGE signaling, both in the orbit and peripheral blood, compared with non-smoking patients. Enhancement of inflammatory status was associated with activation of the ROS-nuclear factor-kappa B pathway downstream of RAGE. RAGE gene interference or administration of RAGE inhibitor effectively mitigated cigarette smoking-related pathological changes in OFs. Disrupting RAGE signaling in TED mice efficiently ameliorated smoking-induced disease progression <i>in vivo</i>. <b><i>Conclusions:</i></b> Cigarette smoking-relevant TED progression was linked with RAGE signaling activation, leading to the exacerbation of orbital inflammation and tissue-remodeling, including fibrosis and adipogenesis. Our findings demonstrate that cigarette smoke exposure affects the biological characteristics of TED-derived OFs and supports RAGE as a promising therapeutic target for the management of patients with TED and smoking habits.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed Thyrotropin Rise in Preterm Newborns: Value of Multiple Screening Samples and of a Detailed Clinical Characterization.","authors":"Emese Boros, Lionel Marcelis, Claudine Heinrichs, Vinciane Vlieghe, Marwa Abdoulmoula, Guy Van Vliet, Cécile Brachet","doi":"10.1089/thy.2025.0051","DOIUrl":"https://doi.org/10.1089/thy.2025.0051","url":null,"abstract":"<p><p><b><i>Background:</i></b> Newborn screening for congenital hypothyroidism (CH) has been implemented in high-income countries since the 1970s to prevent intellectual disability. A delayed thyrotropin (TSH) rise with a normal TSH on the first dry blood spot (DBS) sample, followed by an abnormal TSH on the subsequent DBS, is sometimes observed in preterm newborns. The incidence of permanent CH and the screening process in preterm newborns remain controversial. Our aim was to evaluate the incidence of transient and permanent CH and delayed TSH rise in preterm newborns. The utility of a multiple screening samples is discussed. <b><i>Methods:</i></b> We conducted a retrospective study on preterm newborns (<37 weeks of gestation) screened at the Newborn Screening Center of Université Libre de Bruxelles between January 2014 and December 2023. A literature review was performed to identify cases of permanent CH with delayed TSH rise in cohorts of preterm newborns. <b><i>Results:</i></b> Of the 3578 preterm newborns included in the study, 10 were diagnosed with CH (0.3%). The majority of CH cases were transient (6 out of 10 transient, one deceased and one under ongoing L-thyroxine, too young for weaning attempt). Six cases were detected at the first DBS, four at subsequent DBS. Only two cases were confirmed as permanent CH, yielding an incidence of 1 in 1789 for permanent CH in preterms (0.05%). One of the two had a delayed TSH rise. Genetic testing helped in establishing the diagnosis of permanent CH with gland <i>in situ</i>. <b><i>Conclusions:</i></b> Permanent CH appears to be rarer than transient CH among preterm newborns (1/1789 vs. 1/596). Transient CH may be suspected in case of iodine exposure or thyroid ultrasound showing an <i>in situ</i> gland with negative genetic testing and absent maternal blocking antibodies. In such cases, early L-thyroxine weaning may help avoid overtreatment. A delayed TSH rise leading to a false negative first DBS is not uncommon in preterm newborns with permanent CH. This justifies a second DBS in preterms. Given the retrospective nature of this study, these findings should be interpreted with caution, and further prospective research is warranted to confirm these observations.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Clinical Outcomes of Patients with Differentiated Thyroid Cancer Treated with Lenvatinib: Results from Real-World Practice in Japan.","authors":"Ryutaro Onaga, Tomohiro Enokida, Nobukazu Tanaka, Yuta Hoshi, Takuma Kishida, Ryo Kuboki, Masanobu Sato, Naohiro Takeshita, Hideki Tanaka, Takao Fujisawa, Susumu Okano, Hiroshi Nishino, Makoto Ito, Makoto Tahara","doi":"10.1089/thy.2025.0040","DOIUrl":"https://doi.org/10.1089/thy.2025.0040","url":null,"abstract":"<p><p><b><i>Background:</i></b> Although accumulated experience with lenvatinib in patients with differentiated thyroid cancer (DTC) and progressive radioactive iodine (RAI)-refractory disease has been used to improve management strategies for this disease, findings regarding the actual clinical picture and long-term observation data are insufficient. <b><i>Methods:</i></b> We conducted a retrospective cohort study of patients with DTC who received lenvatinib treatment from 2011 to 2022 at the National Cancer Center Hospital East, Japan. The patients were treated under the following treatment and management policies (1) starting dose at 24 mg/day, (2) schedule modification according to individual adverse events status (planned drug holidays), (3) dose escalation of lenvatinib, and (4) local therapy at disease progression, if applicable. This is a retrospective cohort study, although some patients were enrolled in a prospective clinical trial (NCT01321554 and UMIN000022243). <b><i>Results:</i></b> Of 91 patients, 59 (64.8%) had papillary carcinoma and 22 (24.2%) had follicular carcinoma. Best overall response in all patients was 60.4% (partial response in 55 and complete response in 0). With a median observation period of 2.9 years (range, 0.1-12.4; interquartile range, 1.7-4.6) under supportive management, including the planned drug holidays (<i>n</i> = 72, 79.1%), dose escalation of lenvatinib at systemic disease progression (<i>n</i> = 21, 23.1%), and local therapy for oligoprogressive disease (<i>n</i> = 11, 12.1%), median progression-free survival and overall survival were 2.4 years (95% confidence interval [CI] 1.9-3.3) and 5.1 years (95% CI 3.3-6.7), respectively. At the time of data cutoff, 19.8% had discontinued lenvatinib treatment due to adverse events, although no adverse event was grade 5. <b><i>Conclusions:</i></b> In patients with RAI-refractory DTC treated with lenvatinib, careful treatment optimization and management of adverse events contribute to a favorable, durable prognosis.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Letter:</i> Amiodarone-Induced Thyrotoxicosis Following Semaglutide-Associated Weight Loss.","authors":"Ilaria Giordani, Gerasimos P Sykiotis","doi":"10.1089/thy.2025.0145","DOIUrl":"https://doi.org/10.1089/thy.2025.0145","url":null,"abstract":"","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Progression-Free Survival in Familial Non-Medullary Thyroid Cancer and Sporadic Differentiated Thyroid Cancer Patients.","authors":"Elias Chuki, Noha Behairy, Sungyoung Auh, Andrew Makarewicz, Chandra Nayan Uttarkar Vikram, Sonam Kumari, Padmasree Veeraraghavan, Craig Cochran, Sriram Gubbi, Joanna Klubo-Gwiezdzinska","doi":"10.1089/thy.2024.0588","DOIUrl":"10.1089/thy.2024.0588","url":null,"abstract":"<p><p><b><i>Background:</i></b> Familial non-medullary thyroid carcinoma (FNMTC) accounts for approximately 9% of differentiated thyroid cancer (DTC). There is conflicting data on the FNMTC aggressiveness compared with sporadic DTC (sDTC), leading to usually more extensive therapy applied for FNMTC, given its autosomal dominant genetic background. This study aimed to compare the progression-free survival (PFS) in patients with FNMTC and sDTC treated with standard therapy. <b><i>Methods:</i></b> This longitudinal retrospective cohort study included patients with FNMTC, defined as at least two first-degree relatives affected by DTC. FNMTC patients were matched with sDTC in a 1:3 ratio based on age, sex, American Thyroid Association recurrence risk stratification (ATA-R), extent of initial surgery, and diagnosis date. The primary outcome was PFS. Kaplan-Meier curves were used to compare PFS between the groups, and the Cox proportional hazards model was used to assess confounders. <b><i>Results:</i></b> From 95 affected FNMTC patients, 30 were excluded due to lack of follow-up data. The study population consisted of 65 FNMTC and 170 sDTC patients, with a median follow-up of 4.73 (2.87-10.27) years for FNMTC and 5.83 (2.33-10.79) years for sDTC (<i>p</i> = 0.76). There was 100% matching for ATA-R, sex, surgery type, and year of surgery and a satisfactory matching for age (43.12 ± 15.11 vs. 42.76 ± 12.46 years, <i>p</i> = 0.85). FNMTC exhibited a smaller tumor size (1.20 ± 0.96 vs. 1.89 ± 1.51 cm, <i>p</i> < 0.01) and fewer positive lymph nodes (range 0-13 vs. 0-38, <i>p</i> = 0.009) at presentation. The rate of repeated neck surgeries for persistent/recurrent disease was comparable between the groups: 13.8% (9/65) for FNMTC vs. 17.7% (30/170) for sDTC (<i>p</i> = 0.48). There was no difference in radioactive iodine (RAI) therapy dosage between the groups (104 [100-149] vs. 106 [76-160] mCi<i>, p =</i> 0.82). During follow-up, 15.4% of FNMTC and 18.2% of sDTC patients experienced disease progression (<i>p</i> = 0.61). PFS was non-different between groups (<i>p</i> = 0.56) and was associated with ATA-R (high vs. low hazard ratio [HR]: 9.2, confidence interval [CI]: 2.67-31.85, <i>p</i> < 0.001) and sex (male vs. female, HR: 2.5, CI: 1.11-5.6, <i>p</i> = 0.026). <b><i>Conclusions:</i></b> No difference in PFS between FNMTC and sDTC patients suggests comparable responsiveness to standard therapy. Therefore, the management of FNMTC should align with the standard of care for DTC to avoid overtreatment of FNMTC.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"642-651"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional Differences in the Management of Thyroid Eye Disease: Results from an International Clinical Practice Survey of Endocrinologists.","authors":"Danilo Villagelin, David S Cooper, Henry B Burch","doi":"10.1089/thy.2024.0759","DOIUrl":"10.1089/thy.2024.0759","url":null,"abstract":"<p><p><b><i>Background:</i></b> Over the past several decades, there have been indications of potential shifts in the diagnostic strategies and treatment of patients with Graves' disease (GD) and thyroid eye disease (TED). The objective of this study was to evaluate current practices in managing GD when complicated by moderate-to-severe TED worldwide. <b><i>Methods:</i></b> We recently reported results from a global online survey of endocrinologists comparing the management of GD in different scenarios. The current analysis focuses on regional differences in the diagnosis and treatment of GD when complicated by TED. <b><i>Results:</i></b> A total of 1252 respondents from 85 countries completed the survey. Regarding the initial diagnostic and treatment measures, there were no differences among the various geographical regions. Regarding the treatment of moderate-to-severe TED, the use of sodium selenite was higher in Europe (66.5%) and Oceania (60%) compared to other regions (<i>p</i> < 0.001). North American respondents were more likely to recommend teprotumumab and less likely to use glucocorticoids (<i>p</i> < 0.001). When comparing the treatment options for GD in patients with TED, although prolonged use of antithyroid drugs (ATD) remained the first choice in all regions, respondents from Europe, North America, and Oceania were more likely to recommend thyroidectomy than those from other regions (<i>p</i> < 0.001). Ophthalmologists, rather than endocrinologists, would more often be responsible for prescribing advanced medical therapy for TED in North America, Oceania, and Africa, while endocrinologists would have primary responsibility in other regions of the globe. <b><i>Conclusions:</i></b> Although there are regional differences, respondents generally employ the recommended diagnostic tools, treatments, and a multidisciplinary approach suggested by current clinical practice guidelines. However, there were examples of deviations from current guidance from professional societies.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"676-683"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Deep Learning-Based Artificial Intelligence Model Assisting Thyroid Nodule Diagnosis and Management: Pilot Results for Evaluating Thyroid Malignancy in Pediatric Cohorts.","authors":"Eun Ju Ha, Jeong Hoon Lee, Natalie Mak, Allison K Duh, Elizabeth Tong, Kristen W Yeom, Kara D Meister","doi":"10.1089/thy.2024.0627","DOIUrl":"10.1089/thy.2024.0627","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Artificial intelligence (AI) models have shown promise in predicting malignant thyroid nodules in adults; however, research on deep learning (DL) for pediatric cases is limited. We evaluated the applicability of a DL-based model for assessing thyroid nodules in children. <b><i>Methods:</i></b> We retrospectively identified two pediatric cohorts (<i>n</i> = 128; mean age 15.5 ± 2.4 years; 103 girls) who had thyroid nodule ultrasonography (US) with histological confirmation at two institutions. The AI-Thyroid DL model, originally trained on adult data, was tested on pediatric nodules in three scenarios axial US images, longitudinal US images, and both. We conducted a subgroup analysis based on the two pediatric cohorts and age groups (≥14 years vs. < 14 years) and compared the model's performance with radiologist interpretations using the Thyroid Imaging Reporting and Data System (TIRADS). <b><i>Results:</i></b> Out of 156 nodules analyzed, 47 (30.1%) were malignant. AI-Thyroid demonstrated respective area under the receiver operating characteristic (AUROC), sensitivity, and specificity values of 0.913-0.929, 78.7-89.4%, and 79.8-91.7%, respectively. The AUROC values did not significantly differ across the image planes (all <i>p</i> > 0.05) and between the two pediatric cohorts (<i>p</i> = 0.804). No significant differences were observed between age groups in terms of sensitivity and specificity (all <i>p</i> > 0.05) while the AUROC values were higher for patients aged <14 years compared to those aged ≥14 years (all <i>p</i> < 0.01). AI-Thyroid yielded the highest AUROC values, followed by ACR-TIRADS and K-TIRADS (<i>p</i> = 0.016 and <i>p</i> < 0.001, respectively). <b><i>Conclusion:</i></b> AI-Thyroid demonstrated high performance in diagnosing pediatric thyroid cancer. Future research should focus on optimizing AI-Thyroid for pediatric use and exploring its role alongside tissue sampling in clinical practice.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"652-661"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}