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Diagnostics
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Thyroid Cancer: Types, Symptoms, Diagnosis and Management
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Thyroid Cancer: Types, Symptoms, Diagnosis and Management

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 28 February 2026 | Viewed by 1621

Special Issue Editors

Dr. Mara Carsote

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Guest Editor
1. Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
2. Department of Endocrinology, C.I. Parhon National Institute of Endocrinology, 011863 Bucharest, Romania
Interests: thyroid; adrenal; pituitary; osteoporosis; neuroendocrine tumors; bone; fracture; gynecological endocrinology; diabetes
Special Issues, Collections and Topics in MDPI journals
Dr. Mihai-Lucian Ciobica

E-Mail Website
Guest Editor
1. Department of Internal Medicine and Gastroenterology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
2. Department of Internal Medicine I and Rheumatology, “Dr. Carol Davila” Central Military University Emergency Hospital, 010825 Bucharest, Romania
Interests: thyroid ultrasound; internal medicine; autoimmune (including thyroid) diseases; neuroendocrine neoplasia
Dr. Claudiu Nistor

E-Mail Website
Guest Editor
1. Department 4—Cardio-Thoracic Pathology, Thoracic Surgery II Discipline, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
2. Thoracic Surgery Department, “Dr. Carol Davila” Central Emergency University Military Hospital, 013058 Bucharest, Romania
Interests: thyroid surgery; parathyroid surgery; lung neuroendocrine tumors; lung cancer; minimally invasive surgery; VATS; cervico-mediastinal surgery; thoracic-abdominal surgery; pleuro-pericardial disease; chest wall tumors
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are pleased to invite you to contribute to the Special Issue "Thyroid Cancer: Types, Symptoms, Diagnosis, and Management". This Special Issue delves into the complexities of this disease, covering its diverse types, ranging from papillary to anaplastic carcinomas. It highlights the often subtle symptoms that may precede diagnosis, emphasizing the importance of awareness and early detection. This Special Issue explores diagnostic modalities, including imaging and biopsy, crucial for accurate staging and subtype identification. Management strategies discussed encompass surgical resection, radioactive iodine therapy, hormone replacement, and innovative targeted therapies, tailored to individual patient needs and cancer characteristics. The goal is to improve outcomes and quality of life for thyroid cancer patients. We are interested in receiving contributions on the following topics:

The interplay with autoimmune thyroid disease;

The new WHO classification of thyroid conditions;

Molecular and genetic markers;

Multidisciplinary strategies of approach;

Collision tumours of the thyroid;

Post-pandemic updates in the field of thyroid cancer;

Genetic background: traditional and emergent testing;

RET pathogenic variants and multiple endocrine neoplasias;

BRAF mutation;

Pitfalls and challenges of the surgical approach in thyroid cancer, including the following:

  1. Post-operatory complications (hypoparathyroidism, recurrent laryngeal nerve injury, bleeding, seroma, hematoma, and neck scars);
  2. Less than total thyroidectomy;
  3. Robotic thyroidectomy;
  4. Axillary and trans-oral thyroidectomy.

Radioiodine use and radioiodine resistant cancer;

Particular populations: pregnancy, children, and the elderly;

Side effects of long-term TSH-suppressive therapy in differentiated thyroid cancer;

Iodination effects in global thyroid cancer presentation;

Updates in the anaplastic thyroid cancer.

Ultrasound, PET-CT, scintigraphy.

Dr. Mara Carsote
Dr. Mihai-Lucian Ciobica
Dr. Claudiu Nistor
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • thyroid neoplasia
  • thyroiditis
  • imaging, functional imaging
  • thyroidectomy
  • tumor markers
  • histological exam
  • molecular findings
  • pediatric population
  • pregnancy and thyroid conditions

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Published Papers (3 papers)

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15 pages, 3399 KB  
Article
Predictive Value of Arterial Enhancement Fraction Derived from Dual-Layer Spectral Computed Tomography for Thyroid Microcarcinoma
by Yuwei Chen, Jiayi Yu, Liang Lv, Zuhua Song, Jie Huang, Bi Zhou, Xinghong Zou, Ya Zou and Dan Zhang
Diagnostics 2025, 15(19), 2427; https://doi.org/10.3390/diagnostics15192427 - 23 Sep 2025
Abstract
Background/Objectives: Accurately distinguishing malignancy in thyroid micronodules (≤10 mm) is crucial for clinical management, yet it is challenging due to the limitations of conventional ultrasonography-guided biopsy. This study aims to evaluate the predictive value of dual-layer spectral computed tomography (DSCT)-derived arterial enhancement fraction [...] Read more.
Background/Objectives: Accurately distinguishing malignancy in thyroid micronodules (≤10 mm) is crucial for clinical management, yet it is challenging due to the limitations of conventional ultrasonography-guided biopsy. This study aims to evaluate the predictive value of dual-layer spectral computed tomography (DSCT)-derived arterial enhancement fraction (AEF) in diagnosing thyroid microcarcinomas. Methods: In the study, 321 pathologically confirmed thyroid micronodules (benign = 131, malignant = 190) from Chongqing General Hospital underwent preoperative DSCT. Quantitative parameters of DSCT, including the normalized iodine concentration (NIC), normalized effective atomic number (NZeff), and slope of the spectral Hounsfield unit curve (λHU(40–100)), were assessed. Both single-energy CT (SECT)-derived AEF (AEFS) and DSCT-derived AEF (AEFD) were calculated. Conventional image features included microcalcifications and enhancement blurring. Correlation between AEFD and AEFS was determined using Spearman’s correlation coefficient. Diagnostic performance was evaluated by calculating the area under the curve (AUC) using receiver operating characteristic (ROC) analysis. Results: Malignant micronodules exhibited significantly lower AEFD (0.958 vs. 1.259, p < 0.001) and AEFS (0.964 vs. 1.436, p < 0.001) versus benign nodules. Arterial phase parameters—APλHU(40–100), APNIC, APNZeff—differed significantly between groups (all p < 0.001), whereas venous phase parameters (VPλHU(40–100), VPNIC, VPNZeff) showed no differences (all p > 0.05). Multivariate analysis revealed that λHU(40–100) as an independent predictor of malignancy, with an odds ratio (OR) of 0.600 (95% confidence interval (CI): 0.437–0.823; p = 0.002) and an AUC of 0.752 (95% CI: 0.698–0.806). A significant positive correlation was identified between AEFD and AEFS (r = 0.710; p < 0.001). For diagnosing malignancy, AEFD demonstrated superior overall performance (AUC: 0.794; sensitivity: 70.5%; specificity: 81.7%; accuracy: 75.1%) to AEFS (0.753; 71.1%; 74.0%; 72.3%), APλHU(40–100) (0.752; 68.9%; 75.6%; 71.7%), and calcification (0.573; 21.6%; 92.4%; 50.5%). Clinically, AEFD reduced the unnecessary biopsy rate to 18.3%, preventing 107 procedures in our cohort. Conclusions: AEFD and AEFS demonstrated strong correlation and comparable diagnostic performance in the evaluation of thyroid micronodules. Furthermore, AEFD showed favorable diagnostic efficacy compared to both spectral parameters and conventional imaging feature. More importantly, the application of AEFD significantly reduced unnecessary biopsy rates, highlighting its clinical value in optimizing patient management. Full article
(This article belongs to the Special Issue Thyroid Cancer: Types, Symptoms, Diagnosis and Management)
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13 pages, 1821 KB  
Article
Thyroid Nodule Characterization: Which Thyroid Imaging Reporting and Data System (TIRADS) Is More Accurate? A Comparison Between Radiologists with Different Experiences and Artificial Intelligence Software
by Emanuele David, Lorenzo Aliotta, Fabrizio Frezza, Marianna Riccio, Alessandro Cannavale, Patrizia Pacini, Chiara Di Bella, Vincenzo Dolcetti, Elena Seri, Luca Giuliani, Mattia Di Segni, Gianmarco Lo Conte, Giacomo Bonito, Antonino Guerrisi, Fabio Mangini, Francesco Maria Drudi, Corrado De Vito and Vito Cantisani
Diagnostics 2025, 15(16), 2108; https://doi.org/10.3390/diagnostics15162108 - 21 Aug 2025
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Abstract
Purpose: This study aimed to compare: the performance of K-TIRADS, EU-TIRADS and ACR TIRADS when used by observers with different levels of experience compared with the gold standard of cytology, and to evaluate the diagnostic performance of CAD (computer-aided design) compared with TI-RADS [...] Read more.
Purpose: This study aimed to compare: the performance of K-TIRADS, EU-TIRADS and ACR TIRADS when used by observers with different levels of experience compared with the gold standard of cytology, and to evaluate the diagnostic performance of CAD (computer-aided design) compared with TI-RADS systems. Methods and Materials: In total, 323 thyroid nodules were evaluated in patients who were candidates for needle aspiration. Three observers with different levels of experience evaluated the diagnostic accuracy of three risk stratification systems (ACR TI-RADS, EU-TIRADS and K-TIRADS) and CAD software (S-Detect, made by Samsung) in characterizing the nodules. The results were compared with cytology examination. All nodules were characterized in terms of shape, margins, composition, calcifications, size, echogenicity and microcalcifications, and by stratifying individual nodules by using the three TIRADS systems; then S-detect software was applied and the data were compared with each other and with the gold standard. Results: Through cytology, 308 benign and 33 malignant nodules were identified. ACR-TIRADS showed a sensitivity of 100%, a specificity of 86%, a positive predictive value of 43% and a negative predictive value of 100%. EU-TIRADS showed a sensitivity of 100%, a specificity of 79%, a positive predictive value of 33% and a negative predictive value of 100%. K-TIRADS showed a sensitivity of 100%, a specificity of 89%, a positive predictive value of 50% and a negative predictive value of 100%. S-Detect combined with EU-TIRADS showed a high agreement (>95%) with the gold standard. Conclusions: K-TIRADS’s positive predictive power was slightly better than the other TIRADS, suggesting greater accuracy in correctly diagnosing positive cases. S-DETECT combined with EU-TIRADS has similar results to S-Detect with ACR- and K-TIRADS in terms of sensitivity, specificity and negative predictive power. However, it has a slightly better positive predictive power, suggesting greater accuracy in correctly diagnosing positive cases than the ACR- and K-TIRADS classification systems. In general, S-Detect cannot yet be considered a substitute for the human observer but only as an important support for human evaluation and an excellent and fast help to provide a comprehensive and complete report. Clinical Relevance/Application: S-Detect is a valuable tool for characterizing thyroid nodules when integrated with radiologist evaluation. It is also an important support tool for less experienced observers. Particularly interesting is the approach of use in integrated combination of the K-TIRADS by the human observer with S-Detect using EU-TIRADS, which could increase the overall diagnostic efficiency of the systems. Full article
(This article belongs to the Special Issue Thyroid Cancer: Types, Symptoms, Diagnosis and Management)
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10 pages, 2422 KB  
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Multilayered Insights into Poorly Differentiated, BRAFV600E-Positive, Thyroid Carcinoma in a Rapidly Developing Goiter with Retrosternal Extension: From En “Y” Cervicotomy to SPECT/CT-Positive Lung Metastases
by Oana-Claudia Sima, Anca-Pati Cucu, Dana Terzea, Claudiu Nistor, Florina Vasilescu, Lucian-George Eftimie, Mihai-Lucian Ciobica, Mihai Costachescu and Mara Carsote
Diagnostics 2025, 15(16), 2049; https://doi.org/10.3390/diagnostics15162049 - 15 Aug 2025
Viewed by 513
Abstract
Poorly differentiated thyroid malignancy, a rare histological type of aggressive thyroid malignancy with associated difficulties and gaps in its histological and molecular characterization, might lead to challenging clinical presentations that require a prompt multimodal approach. This case study involved a 56-year-old, non-smoking male [...] Read more.
Poorly differentiated thyroid malignancy, a rare histological type of aggressive thyroid malignancy with associated difficulties and gaps in its histological and molecular characterization, might lead to challenging clinical presentations that require a prompt multimodal approach. This case study involved a 56-year-old, non-smoking male with a rapidly developing goiter (within 2–3 months) in association with mild, non-specific neck compressive symptoms. His medical history was irrelevant. A voluminous goiter with substernal and posterior extension up to the vertebral bodies was detected using an ultrasound and computed tomography (CT) scan and required emergency thyroidectomy. He had normal thyroid function, as well as negative thyroid autoimmunity and serum calcitonin. The surgery was successful upon “Y” incision, which was used to give better access to the retrosternal component in order to avoid a sternotomy. Post-operatively, the subject developed hypoparathyroidism-related hypocalcemia and showed a very high serum thyroglobulin level (>550 ng/mL). The pathological report confirmed poorly differentiated, multifocal thyroid carcinoma (with an insular, solid, and trabecular pattern) against a background of papillary carcinoma (pT3b, pN0, and pM1; L1; V2; Pn0; R1; and stage IVB). The subject received 200 mCi of radioiodine therapy for 6 weeks following the thoracic surgery. Whole-body scintigraphy was performed before radioiodine therapy and showed increased radiotracer uptake at the thyroid remnants and pre-tracheal levels. Additionally, single-photon emission computed tomography combined with CT (SPECT/CT) was performed, and confirmed the areas of intense uptake, in addition to a moderate uptake in the right and left pulmonary parenchyma, suggesting lung metastasis. To conclude, an overall low level of statistical evidence exists regarding poorly differentiated malignancy in substernal goiters, and the data also remains scarce regarding the impact of genetic and molecular configurations, such as the BRAF-positive profile, in this specific instance. Furthermore, multimodal management includes additional diagnosis methods such as SPECT/CT, while long-term multilayered therapy includes tyrosine kinase inhibitors if the outcome shows an iodine-resistant profile with a poor prognosis. Awareness remains a key factor in cases of a poorly differentiated carcinoma presenting as a rapidly growing goiter with substernal extension in an apparently healthy adult. A surgical approach, while varying with the surgeon’s skills, represents a mandatory step to ensure a better prognosis. In addition to a meticulous histological characterization, genetic/molecular features provide valuable information regarding the outcome and can further help with the decision to use new anti-cancer drugs if tumor response upon radioiodine therapy is no longer achieved; such a development is expected in this disease stage in association with a BRAF-positive configuration. Full article
(This article belongs to the Special Issue Thyroid Cancer: Types, Symptoms, Diagnosis and Management)
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