Thyroid最新文献

{"title":"CT-Free Quantitative Thyroid SPECT Based on Artificial Intelligence: A Prospective Multicenter Noninferiority Clinical Trial.","authors":"Hyun Woo Chung, Sang-Geon Cho, Dongkyu Oh, Kyounghyoun Kwon, Ji Hye Kim, Young So, Jae Hoon Moon, Soyeon Ahn, Won Woo Lee","doi":"10.1177/10507256261440401","DOIUrl":"10.1177/10507256261440401","url":null,"abstract":"<p><strong>Background: </strong>Hybrid single-photon emission computed tomography (SPECT)/computed tomography (CT) is used for the differential diagnosis of thyrotoxicosis, but its dependence on CT and complex analysis remains debated. This study evaluated whether CT-free thyroid SPECT using artificial intelligence (AI) could substitute for conventional SPECT/CT.</p><p><strong>Methods: </strong>This prospective multicenter noninferiority clinical trial (KCT0008387) included 152 patients with thyrotoxicosis from three tertiary referral hospitals. A pretrained AI model generated technetium thyroid uptake (TcTU) values using SPECT images without CT. These values were compared with TcTU derived from conventional SPECT/CT. The primary endpoint was diagnostic accuracy for Graves' disease. Noninferiority was defined as a lower confidence interval (CI) limit greater than -10%. Secondary endpoints included diagnostic accuracy for destructive thyroiditis and prediction of antithyroid drug (ATD) prescription within one month.</p><p><strong>Results: </strong>Among 152 patients, 84 had Graves' disease, 45 had indeterminate disease, and 23 had thyroiditis. For Graves' disease, CT-free SPECT demonstrated 86.2% accuracy compared with 85.5% for conventional SPECT/CT. The lower bound of the CI of the accuracy difference was -3.0%, meeting the prespecified noninferiority margin. For thyroiditis and ATD prescription, the lower bounds were -7.4% and -3.2%, respectively. Omission of CT resulted in a 33.5% reduction of radiation exposure from 3.34 mSv to 2.22 mSv, and CT-free SPECT automatically generated TcTU values more quickly than SPECT/CT (40 minutes vs. 4 minutes).</p><p><strong>Conclusions: </strong>CT-free SPECT using AI demonstrated noninferior diagnostic performance for thyrotoxicosis compared with conventional hybrid imaging while reducing radiation exposure and analysis time.</p><p><strong>Trial registration: </strong>https://cris.nih.go.kr (KCT0008387).</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"770-778"},"PeriodicalIF":6.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628436","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":"Risk Stratification Tools for Thyroid Cancer: A Systematic Review of Models Combining Ultrasound, Cytology, and Clinical Risk Factors.","authors":"Emma Watts, Zakariya Sattar, Kristien Boelaert, Neil Sharma","doi":"10.1177/10507256261448300","DOIUrl":"10.1177/10507256261448300","url":null,"abstract":"<p><strong>Background: </strong>The rising incidence of thyroid cancer presents a growing diagnostic and therapeutic challenge. Various risk stratification systems have sought to integrate clinical, ultrasonographic, and, in some cases, cytological features to aid malignancy prognostication. This systematic review aims to critically evaluate risk stratification tools (RSTs) for patients with thyroid nodules, which incorporate multimodal inputs to assess their diagnostic performance and clinical utility in supporting surgical decision-making.</p><p><strong>Methods: </strong>PubMed, Embase, and Cochrane databases were searched from inception to 04/13/2026, identifying studies evaluating multivariable risk prediction models for adult patients undergoing assessment of thyroid nodules. Studies were excluded if the proposed tool failed to incorporate clinical features, ultrasound findings, and cytology results or was not validated with histology. Data extraction encompassed methodology of model development, performance metrics, and approaches to validation. Risk of bias was assessed using the PROBAST+AI tool.</p><p><strong>Results: </strong>Seven studies describing five distinct RSTs met inclusion criteria Thyroid Nodule App (TNAPP), the McGill Thyroid Nodule Score (MTNS), CUT Score, Memorial Sloan Kettering Cancer Centre (MSKCC) nomogram, and Thyroid Prediction Score (TiPS). TiPS demonstrated the highest sensitivity (96.2%) and specificity (97.5%) with area under the curve (AUC) >0.9. The CUT score also showed strong performance (AUC >0.9), particularly in low-to-intermediate risk nodules. TNAPP underperformed (accuracy 50.5%; specificity 27.5%) despite broad clinical inputs. The MTNS and MSKCC, although promising for indeterminate cytology, lacked robust validation. Most models were derived from single-center, retrospective cohorts, limiting generalizability.</p><p><strong>Conclusions: </strong>RSTs integrating multimodal data may improve thyroid nodule risk stratification, particularly in cases of indeterminate cytology. However, methodological limitations and lack of external validation currently restrict clinical utility. Prospective evaluation in diverse populations is required to identify the most effective and generalizable tools. Until then, RSTs should be used as adjuncts to, not replacements for, clinical judgment and shared decision-making in thyroid nodule assessment.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"707-720"},"PeriodicalIF":6.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843182","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":"Thyroxine Treatment of Adult RTHα Patients: Safety, Efficacy, and Metabolomic Changes.","authors":"Alexander Bauer Westbye, Louise Koren Dahll, May Kristin Bredahl, Per Medbøe Thorsby, Sara Salehi Hammerstad","doi":"10.1177/10507256261460201","DOIUrl":"10.1177/10507256261460201","url":null,"abstract":"<p><strong>Background: </strong>Resistance to thyroid hormone alpha (RTHα) is a rare genetic disorder with symptoms of hypothyroidism, but normal or close-to-normal thyroid function tests. Treatment with levothyroxine (L-T4) may be beneficial. This study investigated the efficacy, safety and biochemical changes of high-dose L-T4 and liothyronine (L-T3) treatment.</p><p><strong>Methods: </strong>Four RTHα (Ala263Val) patients were treated with L-T4 (1.75 µg/kg) in a pilot open-label study and monitored for three years. Quality of life (QoL) was assessed using ThyPro. Analysis of auxiological- and biochemical-parameters, bone mineral density (BMD) and exploratory metabolomics was performed. A partial replacement of L-T4 with L-T3 was attempted.</p><p><strong>Results: </strong>Treatment with L-T4 increased FT4, FT3, and rT3 to supraphysiological concentrations (relative to reference intervals) and suppressed thyroid-stimulating hormone with no adverse effects. Heart rate, bone markers, and sex hormone-binding globulin transiently increased. Several classes of lipids were reduced. BMD appeared unaltered. Patients reported improved QoL. One patient presented a short non-sustained ventricular tachycardia on L-T3 + L-T4.</p><p><strong>Conclusions: </strong>L-T4 treatment of adult RTHα patients was safe and improved QoL in adherent patients.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"788-794"},"PeriodicalIF":6.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219021","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":"Empirical Thyrotropin-Free Thyroxine Relationship Across the Thyrotropin Spectrum and Implications for Reference Intervals.","authors":"Toshihiko Kasahara","doi":"10.1177/10507256261445291","DOIUrl":"10.1177/10507256261445291","url":null,"abstract":"<p><strong>Background: </strong>The relationship between thyrotropin (TSH) and free thyroxine (FT4) is commonly assumed to be log-linear. However, this assumption may oversimplify hypothalamic-pituitary-thyroid axis regulation. Characterizing the empirical structure of this relationship could inform the interpretation of thyroid function tests and the validity of current TSH reference intervals. Segmented regression was used to examine the TSH-FT4 relationship to determine whether statistically derived TSH breakpoints corresponded to the current reference limits.</p><p><strong>Methods: </strong>This study retrospectively analyzed 782 paired TSH-FT4 measurements obtained from untreated outpatients (median age, 43 years; interquartile range, 33-54 years) between July 2021 and March 2024. Patients positive for TSH receptor antibodies were excluded. Measurements obtained during treatment with levothyroxine, liothyronine, or antithyroid drugs, as well as those obtained during pregnancy, were also excluded. Segmented regression was used to model FT4 as a function of log-transformed TSH and identify the optimal breakpoints.</p><p><strong>Results: </strong>Model comparison using the Akaike Information Criterion indicated that the two-breakpoint model provided the best fit. Breakpoints occurred at TSH values of 0.22 and 4.25 mIU/L, partitioning the relationship into three segments with distinct slopes. The lower breakpoint closely matched the assay-specific lower reference limit (0.27 mIU/L) but lay below the harmonized lower reference limits in Japan and the United States, whereas the upper breakpoint was close to both the assay-specific upper limit (4.20 mIU/L) and the corresponding harmonized upper limits (4.23 and 4.27 mIU/L, respectively). FT4 changed little across TSH values of 0.22-4.25 mIU/L, consistent with an approximate homeostatic plateau.</p><p><strong>Conclusions: </strong>The TSH-FT4 relationship over the entire functional TSH range is segmented rather than uniformly log-linear, and the interval over which FT4 changes little may represent physiological homeostasis. Population-based TSH reference intervals showed partial concordance with the empirically derived homeostatic range, particularly at the upper end, whereas the lower boundary was less closely aligned. Empirically derived breakpoints and population-based reference intervals may therefore offer complementary perspectives for interpreting borderline biochemical abnormalities.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"800-803"},"PeriodicalIF":6.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730115","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":"Diagnostic Yield of Thyroid Incidentaloma Evaluation and the Impact of Guideline Variability: Insights from a Retrospective Cohort Study.","authors":"Jeresa I A Willems, Daan J L van Twist, Kristy M Pickwell, Patrick L H van Battum, Rutgert Bianchi, Thijs Sluiter, Marco Medici, Robin P Peeters, Roderick F A Tummers-de Lind van Wijngaarden","doi":"10.1177/10507256261440405","DOIUrl":"10.1177/10507256261440405","url":null,"abstract":"<p><strong>Introduction: </strong>Thyroid incidentalomas are lesions detected incidentally on imaging performed for unrelated indications. Determining which lesions warrant further evaluation to exclude malignancy introduces a dilemma: intensive diagnostic strategies maximize malignancy detection but increase diagnostic workload, patient burden, and overdiagnosis of indolent cancers, whereas restrictive approaches reduce these harms but risk missing malignancies. Guidelines balance these opposing considerations differently, resulting in substantial variation in recommendations for evaluating conventional imaging-detected thyroid incidentalomas (ultrasound, computed tomography, magnetic resonance imaging). In this study, we aimed to investigate the diagnostic yield of thyroid incidentaloma evaluation and the impact of guideline variability on malignancy detection and diagnostic workload.</p><p><strong>Methods: </strong>We retrospectively assessed all patients referred to Zuyd Thyroid Center (2018-2023) for thyroid nodule evaluation. Data on diagnostic outcomes, treatments, and complications were collected. A guideline-based simulation analysis examined how applying the European Thyroid Association (ETA; most intensive), the American Thyroid Association (ATA), and the Dutch Federation of Medical Specialists (most restrictive) guidelines would affect malignancy detection and diagnostic workload.</p><p><strong>Results: </strong>Of 1825 referred patients, 630 (34.5%) had one or more incidentalomas (median age 66 years [interquartile range 54-74]; 70.6% female). Malignancy rate was significantly higher for nuclear imaging-detected incidentalomas than for conventional imaging (21.1% vs. 1.8%, <i>p</i> < 0.001). In the guideline-based simulation analysis, ETA recommended evaluating all cases, while ATA (without clinical warning signs) evaluated 85.3%, both identifying all malignancies. The Dutch guideline avoided evaluation in 96.9% of patients, missing 7 malignancies among 528 unevaluated cases (1.3%), all subtypes with good prognosis even if left undetected.</p><p><strong>Conclusions: </strong>Conventional imaging-detected incidentalomas carry a low malignancy risk, resulting in a high diagnostic workload to detect few malignancies. More restrictive evaluation criteria can substantially reduce diagnostic burden but may miss a small number of low-risk malignancies. These findings highlight the need for improved selection criteria that minimize unnecessary procedures while ensuring detection of clinically relevant malignancies.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"779-787"},"PeriodicalIF":6.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691967","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":"Fatigue after Thyroidectomy: A Qualitative Exploration of Patients' Lived Experiences.","authors":"Catherine B Jensen, Elizabeth M Bacon, Steven Xie, Alisha Keshwani, Sarah E Bradley, J Denard Thomas, Susan C Pitt","doi":"10.1177/10507256261450430","DOIUrl":"10.1177/10507256261450430","url":null,"abstract":"<p><strong>Introduction: </strong>Fatigue is a common, yet understudied, patient-reported symptom after thyroidectomy. This study sought to explore patients' lived experience of fatigue post-thyroidectomy.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with adult patients who underwent thyroidectomy for benign and malignant thyroid disease between January 2021 and January 2024. Data were analyzed by qualitative content analysis.</p><p><strong>Results: </strong>Participants (<i>n</i> = 20) were a median of 44 years (range 21-73). The majority were female (90%), White (75%), diagnosed with thyroid cancer (45%), and had undergone a total thyroidectomy (50%). Most participants (75%) spontaneously discussed experiencing fatigue post-thyroidectomy, describing their physical symptoms related to fatigue as \"<i>tiredness</i>\", \"<i>exhaustion</i>\", or \"<i>decreased energy</i>\". Qualitative results could be organized into three domains describing participant experience with fatigue: (i) the impact of fatigue on their life (including impacts on work, day-to-day life, and social interactions), (ii) beliefs about the source of fatigue (such as medication), and (iii) expectations about fatigue as an outcome. Participants also discussed fatigue in relation to other life stresses and non-thyroid comorbidities. Most patients were underprepared for the possibility and severity of fatigue post-thyroidectomy. Participants suggested that surgeons \"<i>bringing [fatigue] up</i>\" as a possible outcome could improve patient expectations.</p><p><strong>Conclusions: </strong>Fatigue is a significant outcome after thyroidectomy, affecting every aspect of patients' lives. As the first in-depth qualitative study to describe patients' experience with fatigue, this study highlights the need for further research to improve patient expectations and elucidate underlying mechanisms leading to post-thyroidectomy fatigue.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"760-769"},"PeriodicalIF":6.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964544","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":"Prevalence and Clinical Characteristics of Macro-TSH in Patients with Subclinical Hypothyroidism.","authors":"Eijun Nishihara, Shuji Fukata, Chisako Imamura, Mitsuru Ito, Mitsushige Nishikawa, Akira Miyauchi, Takashi Akamizu","doi":"10.1177/10507256261456988","DOIUrl":"10.1177/10507256261456988","url":null,"abstract":"<p><strong>Background: </strong>Macro-thyrotropin (TSH) is a high molecular weight complex of TSH associated with apparently elevated levels of serum TSH, which can lead to an incorrect diagnosis of subclinical hypothyroidism. Given that levothyroxine (LT4) replacement is unnecessary in such cases, the accurate identification of macro-TSH based on clinical and laboratory findings is of particular importance. We aimed to determine the prevalence and clinical features of macro-TSH in patients with subclinical hypothyroidism evaluated after the introduction of TSH harmonization.</p><p><strong>Patients and methods: </strong>Between August and November 2023, we included 1599 consecutive patients with subclinical hypothyroidism (TSH > 4.23 mIU/L with normal fT4 levels) who were either untreated or receiving LT4 replacement monotherapy. Polyethylene glycol (PEG) precipitation was performed in all cases. Patients with TSH recovery of <20% underwent further evaluation, including gel filtration chromatography under neutral and acidic conditions, protein G and Jacalin precipitation assays, and a comprehensive battery of interference tests.</p><p><strong>Results: </strong>Four patients (0.25%) showed high molecular-weight TSH peaks (>150 kDa) under neutral conditions that disappeared under acidic conditions, with a shift to the native molecular weight (approximately 28 kDa), indicating the initial presence of macro-TSH. The TSH complex was detected in peaks corresponding to IgG, IgA, and IgM. These findings were verified using Protein G and Jacalin precipitation assays, with no evidence of assay interference. Reevaluation of TSH recovery following PEG precipitation showed substantial variation in two patients who had abundant monomeric TSH compared with the high-molecular complex. All four patients with macro-TSH had previously received LT4 therapy, which resulted in a modest reduction in TSH levels, with three of these patients testing positive for TgAb and/or TPOAb.</p><p><strong>Conclusions: </strong>Macro-TSH complexes comprise several immunoglobulin isotypes. In cases with low antibody-TSH binding affinity and positive antithyroid autoantibodies, TSH levels may fluctuate during the clinical course, thereby complicating diagnosis and management.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"721-728"},"PeriodicalIF":6.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158141","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":"Comparative Analysis of Elevated Serum Total and Free Triiodothyronine Results Obtained by Immunoassays.","authors":"Roger Frigério Castilho, Rafael Almeida de Almeida, Cintia Heloisa Correa Pilenso Lintz, Carolina Carvalho Ribeiro-do-Valle, Denise Engelbrecht Zantut-Wittmann","doi":"10.1177/10507256261450106","DOIUrl":"10.1177/10507256261450106","url":null,"abstract":"<p><strong>Background: </strong>Measurement of triiodothyronine (T3) levels is important for the laboratory diagnosis and management of certain cases of thyrotoxicosis and for identifying conditions involving altered peripheral conversion of thyroxine (T4) to T3. However, whether total T3 (TT3) or free T3 (FT3) should be measured remains unclear.</p><p><strong>Methods: </strong>In this study, we performed a retrospective analysis of the results from 605 blood samples from 465 patients, in which thyroid-stimulating hormone (TSH), free T4 (FT4), TT3, and FT3 levels were measured in parallel. All the parameters were quantified using a widely used, fully automated electrochemiluminescence immunoassay platform, and reference intervals were based on those provided by the diagnostic test manufacturer.</p><p><strong>Results: </strong>Despite a strong correlation between the TT3 and FT3 values (T3T ≤ 200 ng/dL: b = 0.0020, 95% confidence interval [CI]: 0.0019-0.0021, r = 0.841; T3T > 200 ng/dL: b = 0.0054, 95% CI: 0.0044-0.0064, r = 0.855), among 41 patients with elevated T3 values, 13 showed elevation of either TT3 or FT3, with a mild discordance between these values. Analysis of these discordant cases revealed a predominant pattern in which the FT3 levels better reflect clinical features and TSH and FT4 results than TT3 levels.</p><p><strong>Conclusions: </strong>The TT3 and FT3 results were generally well correlated, with elevated FT3 demonstrating performance superior to that of elevated TT3. Future studies should validate these findings across diverse populations with specific reference intervals and multiple immunoassay platforms.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"795-799"},"PeriodicalIF":6.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864483","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>Retraction Notice:</i> High Iodine Concentration Attenuates <i>RET/PTC3</i> Oncogene Activation in Thyroid Follicular Cells.","authors":"","doi":"10.1177/10507256261457312","DOIUrl":"10.1177/10507256261457312","url":null,"abstract":"","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"810"},"PeriodicalIF":6.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309507","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":"The American Thyroid Association Multidisciplinary Consensus Statement on Ambulatory Thyroid Surgery.","authors":"Salem I Noureldine, Carolyn D Seib, Erin J Buczek, Marianne David, Jagdish K Dhingra, Ian Ganly, Benjamin C James, Nadia Khoury, Biren P Modi, Sareh Parangi, Susan C Pitt, Jonathon O Russell, Merry E Sebelik, Pinar J Smith, Meredith J Sorensen, Michael R Starks, Mark E Zafereo, J Pieter Noordzij","doi":"10.1177/10507256261442596","DOIUrl":"10.1177/10507256261442596","url":null,"abstract":"<p><strong>Background: </strong>This multidisciplinary consensus statement aims to update the 2013 American Thyroid Association statement on outpatient thyroidectomy by refining the eligibility criteria for safe ambulatory thyroid surgery based on interval published data. Evidence-based perioperative factors essential for optimizing ambulatory care after thyroid surgery are outlined here.</p><p><strong>Summary: </strong>This summary statement highlights four essential aspects for safe outpatient thyroid surgery evaluating preoperative eligibility, optimizing operative planning and techniques, implementing structured postoperative protocols, and ensuring effective preparation for and management of complications. Various factors may serve as relative contraindications to ambulatory thyroid surgery, including patient comorbidities, as well as clinical, social, procedural, and facility-related characteristics. Key operative factors include the choice of anesthesia, use of nerve monitoring, hemostasis, surgical technique, and management of the parathyroid glands. Postoperative care should include clear discharge criteria and protocols that ensure prompt identification and management of complications, including bleeding, airway compromise, and significant hypocalcemia. Ensuring patient education and fostering collaboration among nursing staff, surgeons, and anesthesiologists to develop treatment pathways are essential for the success of ambulatory thyroid surgery. They optimize the patient experience and long-term outcomes while mitigating perioperative risks.</p><p><strong>Conclusions: </strong>Ambulatory thyroid surgery can be performed safely in carefully selected and well-informed patients, provided appropriate precautionary perioperative measures are implemented to enhance communication and improve patient outcomes.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"561-581"},"PeriodicalIF":6.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057207","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}