Thyroid最新文献

{"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":"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":"738-747"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","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":"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":"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":"803-815"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","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":"Inactivation of Thyroid Hormone Transporters Mct8/Oatp1c1 in Mouse Brain Endothelial Cells Causes Region-Specific Alterations in Central Thyroid Hormone Signaling.","authors":"Androniki Alevyzaki, Boyka Markova, Meri De Angelis, Timo D Müller, Akila Chandrasekar, Helge Müller-Fielitz, Markus Schwaninger, Anita Boelen, Dagmar Führer, Steffen Mayerl, Heike Heuer","doi":"10.1089/thy.2025.0089","DOIUrl":"10.1089/thy.2025.0089","url":null,"abstract":"<p><p><b><i>Background:</i></b> Mice lacking the thyroid hormone (TH) transporters monocarboxylate transporter 8 (Mct8) and organic anion transporter 1c1 (Oatp1c1) exhibit a strongly perturbed brain maturation, thereby replicating symptoms of patients with MCT8 deficiency. Mct8/Oatp1c1 double knockout (DKO) mice show a strongly diminished TH brain content, indicating a compromised TH passage across blood-brain barrier (BBB) endothelial cells that may represent a major pathogenic event causing CNS abnormalities. Here, we tested this hypothesis by generating mice that lack Mct8 and Oatp1c1 in endothelial cells only. <b><i>Methods:</i></b> Adult conditional Mct8/Oatp1c1 mice expressing a constitutively active Tek-driven Cre recombinase (Endo del mice) and control littermates were characterized regarding their hypothalamus-pituitary-thyroid axis, brain morphology as well as peripheral and central TH signaling. For comparison, age-matched DKO mice were included. Immunofluorescence (IF) studies were conducted to examine neural maturation. Fluorescence <i>in situ</i> hybridization (FISH) experiments and qPCR analysis were performed to determine transcript levels of TH-regulated genes in different brain regions. TH tissue content in dissected brain areas was quantified by LC-MS/MS analysis. <b><i>Results:</i></b> Analysis of different brain parameters by IF staining revealed a compromised maturation of cortical GABAergic interneurons and hypomyelination in Endo del mice, although the observed alterations were less profound than in DKO mice. TH content determination, FISH, and qPCR studies disclosed significantly reduced TH concentrations and, consequently, decreased TH signaling in several brain areas. Surprisingly, hippocampal T3 content and transcript levels of TH-regulated genes were found to be only mildly altered in Endo del mice compared with DKO animals. <b><i>Conclusions:</i></b> Deficiency of Mct8 and Oatp1c1 in endothelial cells results in reduced murine brain TH content and TH action, thereby underscoring the major function of BBB endothelial Mct8/Oatp1c1 in facilitating TH uptake into the CNS. Yet, the degree of central TH deficiency and neural impairments in Endo del mice are not as profound as in DKO mice. Particularly, unaltered hippocampal T3 signaling suggests a sufficient T3 supply of this brain area, possibly via the cerebrospinal fluid (CSF). These findings infer that apart from the BBB, additional Mct8/Oatp1c1-facilitated TH transmembrane passages (for instance, TH transport across the blood-CSF barrier) are required for proper mouse brain development and function.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"816-827"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576323","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>Correction to</i>: \"Effects of Levothyroxine Treatment on Fertility and Pregnancy Outcomes in Subclinical Hypothyroidism: A Systematic Review and Meta-Analysis of Randomized Controlled Trials'' by Sankoda et al. <i>Thyroid 2024;34(4):519-530</i>; doi: 10.1089/thy.2023.0546.","authors":"","doi":"10.1089/thy.2023.0546.correx","DOIUrl":"10.1089/thy.2023.0546.correx","url":null,"abstract":"","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"838"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628983","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":"Deep Learning Discovers New Morphological Features while Predicting Genetic Alterations from Histopathology of Papillary Thyroid Carcinoma.","authors":"Ingrid Marion, Stefan Schulz, Christina Glasner, Jakob Nikolas Kather, Daniel Truhn, Markus Eckstein, Celine Mueller, Aurélie Fernandez, Simone Marquard, Marie Oliver Metzig, Wilfried Roth, Matthias Martin Gaida, Stephanie Strobl, Daniel-Christoph Wagner, Arno Schad, Moritz Jesinghaus, Nils Hartmann, Thomas Johannes Musholt, Julia I Staubitz-Vernazza, Sebastian Foersch","doi":"10.1089/thy.2024.0691","DOIUrl":"10.1089/thy.2024.0691","url":null,"abstract":"<p><p><b><i>Background:</i></b> Papillary thyroid carcinoma (PTC) is the most common malignant tumor of the endocrine system. <i>BRAF</i> mutations occur in 40-60%, <i>panRAS</i> mutations in 10-15%, and different gene fusion events such as <i>RET</i> fusions in 7-35% of these neoplasms. Artificial intelligence (AI) methods could be used to predict genetic changes from conventional histopathological slides. <b><i>Methods:</i></b> In this retrospective study, we used two independent cohorts of patients with PTC, totaling 662 cases for the establishment of our AI pipeline. The Cancer Genome Atlas cohort (496 cases) served as the developmental cohort, while the Mainz cohort (166 cases) served as an independent external test cohort. <i>BRAF</i>, <i>panRAS</i>, and fusion status was determined for all of these patients as target variables. Vision Transformer was trained on digitized annotated hematoxylin and eosin-stained slides for the presence of these alterations. Highest probability image tiles were used to identify new morphological criteria associated with the genetic changes. <b><i>Results:</i></b> The trained model resulted in an area under the receiver operating characteristic curve of 0.882 (confidence interval 0.829-0.931) for <i>BRAF</i>, 0.876 (0.822-0.927) for <i>panRAS</i>, and 0.858 (0.801-0.912) for gene fusions. Accuracy was 79.3% (72.7-85.8%) for <i>BRAF</i>, 89.3% (84.2-94.0%) for <i>panRAS</i>, and 84.7% (78.8-90.2%) for gene fusions. The performance on the validation set was almost identical to that on the test set. Analyzing the highest predictive tiles, novel morphological criteria for fusion-associated PTC could be discovered. <b><i>Conclusions:</i></b> Our study demonstrates that predicting genetic alterations in digitized histopathological slides using AI is feasible in patients with PTC. Our model showed high accuracy in predicting these changes, making it potentially suitable for pre-screening. Explainability approaches uncovered previously undescribed morphological patterns associated with certain genotypes. Providing pathologists with these AI-based features could improve their accuracy. Assuming further positive prospective validation, this discovery could contribute to a deeper understanding of PTC.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"771-780"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554954","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":"Adjuvant Pembrolizumab after Upfront Multimodal Therapy for Stage IVB Anaplastic Thyroid Cancer.","authors":"Maria E Cabanillas, Naifa L Busaidy, G Brandon Gunn, Priyanka C Iyer, Renata Ferrarotto, Maria Gule-Monroe, Anastasios Maniakas, Michelle D Williams, Suyu Liu, Bryan Fellman, Michael Spiotto, Sarah Hamidi, Neal Akhave, Anna Lee, Jennifer R Wang, Luana de Sousa, Vicente R Marczyk, Mark Zafereo, Ramona Dadu","doi":"10.1089/thy.2025.0194","DOIUrl":"10.1089/thy.2025.0194","url":null,"abstract":"<p><p><b><i>Background:</i></b> Anaplastic thyroid cancer (ATC) has historically been almost uniformly fatal. In patients with the loco-regional disease (stage IVB), multimodal therapy (upfront surgery when feasible, radiation +/- concurrent chemotherapy) followed by observation is the current standard of care. <b><i>Methods:</i></b> Stage IVB ATC patients treated with multimodal therapy, followed by adjuvant pembrolizumab were studied. Data were combined from a prospective, phase 2 trial that closed early due to poor accrual, and a retrospective cohort of consecutive patients who received adjuvant pembrolizumab, mirroring the trial eligibility criteria. Patients received adjuvant pembrolizumab starting within 6 weeks after completion of radiation. An age and treatment-matched control arm treated with multimodal therapy without adjuvant pembrolizumab was selected for comparison. The primary objectives included median progression-free survival (PFS) and recurrence rate, and the secondary objective was median overall survival (OS). <b><i>Results:</i></b> Sixteen patients were included in each arm. The median age in both groups was 59 years. The median PDL1 score in the adjuvant pembrolizumab arm was 50% (range, 0-95%). The majority (88%) had upfront surgery in both groups. The median follow-up time was 24.3 months in the adjuvant arm and 56.7 months in the control arm. The median PFS in the adjuvant and control arm was not reached, and 5.4 months [CI: 2.04-16.20], respectively (<i>p</i> = 0.006; HR 0.24 [CI: 0.08, 0.73]). The median OS was not reached in the adjuvant pembrolizumab group. In the control group, the median OS was 31 months [CI: 13.9, NA] (<i>p</i> = 0.009; HR 0.11 [CI: 0.01, 0.83]). The 12-and 24-month survival rates were 80% [CI: 0.51-0.93] and 52% [CI: 0.25-0.74], respectively, in the control arm, whereas all patients in the adjuvant arm were still alive at 1- and 2-years. <b><i>Conclusion:</i></b> Adjuvant pembrolizumab appears to be a safe and effective strategy to prevent recurrences and prolong survival in stage IVB ATC patients following multimodal therapy. Confirmatory studies are needed.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"763-770"},"PeriodicalIF":6.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561246","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":"Multi-Omics-Based Characterization of DNA Methylation Episignatures for Papillary Thyroid Cancer in a Chinese Population.","authors":"Xianhui Ruan, Feng Yang, Mengling Li, Qiman Dong, Weijing Hao, Wei Zhang, Xinwei Yun, Dapeng Li, Jingzhu Zhao, Xuan Qin, Zihan Rong, Taiyan Guo, Lei Wang, Yi Pan, Ming Gao, Minjie Zhang, Xiangqian Zheng","doi":"10.1089/thy.2024.0611","DOIUrl":"10.1089/thy.2024.0611","url":null,"abstract":"<p><p><b><i>Background:</i></b> Thyroid cancer is the most common endocrine malignancy, with papillary thyroid cancer (PTC) accounting for ∼80% of all cases. DNA methylation alterations and gene expression changes in cancer, offer valuable insights into tumor biology and serve as potential clinical biomarkers. However, the functional implications of DNA methylation changes in PTC patients, particularly based on multiomics analysis in the Chinese population, remain insufficiently explored. This study aims to investigate the epigenetic signatures of thyroid cancer and identify the DNA methylation biomarkers for diagnosing PTC in Chinese patients. <b><i>Methods:</i></b> Thyroid cancer tissues (<i>n</i> = 40) and benign thyroid nodule tissues (<i>n</i> = 31) were collected from Chinese patients for global DNA methylation analysis. Gene expression profiles and H3K27ac modifications were also investigated to understand the impacts of epigenetic changes on gene expression. Genome-wide methylation profiling and machine learning methods were employed to differentiate PTC from control samples. <b><i>Results:</i></b> Genome-wide DNA methylation maps revealed significant methylome changes in Chinese PTC tissues. By integrating our data with The Cancer Genome Atlas thyroid cancer methylation profiles, we identified unique hypomethylation patterns associated with thyroid hormone synthesis specifically in Chinese PTC patients. RNA sequencing and H3K27ac modification analysis, along with functional assays, showed that the dysregulated genes in PTC patients are critical for the proliferation, migration, and invasion of thyroid cancer. <b><i>Conclusions:</i></b> Our study provides a comprehensive view of the multi-omics-based, function-guided DNA methylation landscape for Chinese PTC patients. We identified seven functional differentially methylated regions with high sensitivity and specificity for diagnosing thyroid cancer in Chinese patients. Additionally, <i>DHRS3</i> is highlighted as a key player in PTC pathogenesis and shows promise as a valuable biomarker for predicting patient outcomes. This research advances our understanding of DNA methylation in thyroid cancer and underscores the importance of developing population-specific diagnostic tools to improve patient outcomes. However, further validation in larger, independent cohorts is needed to confirm their diagnostic value.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"789-802"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181238","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":"Preview of the 94th Annual American Thyroid Association Meeting.","authors":"Elizabeth E Cottrill, Kristien Boelaert","doi":"10.1089/thy.2025.0360","DOIUrl":"10.1089/thy.2025.0360","url":null,"abstract":"","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"711-713"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576324","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":"Efficacy and Safety of Thermal Ablation for Indeterminate Thyroid Nodules: A Systematic Review of the Literature and Meta-Analysis.","authors":"Hunjong Lim, Se Jin Cho, Younbeom Jeong, So Yeong Jeong, Jung Hwan Baek","doi":"10.1089/thy.2024.0679","DOIUrl":"10.1089/thy.2024.0679","url":null,"abstract":"<p><p><b><i>Background:</i></b> The management of indeterminate thyroid nodules (ITNs), classified as Bethesda III and IV, is challenging due to biopsy limitations in distinguishing benign from malignant nodules. While diagnostic lobectomy is the standard, thermal ablation (TA) is increasingly considered for patients ineligible or unwilling to undergo surgery. This systematic review and meta-analysis therefore evaluate the efficacy and safety of TA for ITNs. <b><i>Methods:</i></b> A comprehensive search of MEDLINE, EMBASE, and COCHRANE databases was conducted through May 11, 2025, for studies on ITNs treated with TA, with ≥12 months of follow-up and reported clinical or safety outcomes. Case reports, abstracts, and reviews were excluded. Two radiologists independently performed data extraction and quality assessment. Outcomes included volume reduction rate (VRR), regrowth, delayed surgeries, malignancy detection, and complications. The Risk of Bias for Nonrandomized Studies (RoBANS) tool was used for quality assessment. A random-effects model synthesized pooled estimates, with heterogeneity quantified by Higgins' <i>I</i>². <b><i>Results:</i></b> A total of 15 studies with 1149 nodules were analyzed, showing progressive VRR increase, plateauing at 48 months. The pooled 12-month VRR was 81.0% (confidence interval: 76.0-85.9%). Hydrodissection significantly improved VRR at 6 months (<i>p</i> = 0.03), while larger nodules were more prone to regrowth. Major complications occurred in 1.8% (21/1149), with no reported metastasis. Regrowth and delayed surgery occurred in 2.3% (26/1149) and 0.3% (4/1149), respectively, with three malignancies upon delayed surgery. <b><i>Conclusions:</i></b> TA may be considered a minimally invasive alternative for ITNs who are not candidates for or decline surgery, demonstrating favorable efficacy and safety. However, study limitations, short follow-up, and residual malignancy risk necessitate careful follow-up, particularly for larger nodules. Advanced TA techniques such as hydrodissection may enhance outcomes by increasing the likelihood of complete ablation. Long-term prospective studies and randomized trials are needed to confirm TA's role in clinical practice.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":"35 7","pages":"748-762"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638166","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}