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Diagnostics
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Diagnosis and Management of Thyroid Disorders
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Diagnosis and Management of Thyroid Disorders

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: 31 October 2025 | Viewed by 4966

Special Issue Editor

Dr. Vladan Zivaljevic

E-Mail Website
Guest Editor
1. School of Medicine, University of Belgrade, Belgrade, Serbia
2. University Clinical Center of Serbia, Belgrade, Serbia
Interests: endocrine surgery

Special Issue Information

Dear Colleagues,

It is my pleasure to invite you to contribute to this Special Issue “Diagnosis and Management of Thyroid Disorders”.

Thyroid disorder is an umbrella term which comprises a wide spectrum of disorders that affect the function and/or size of the thyroid gland. The most common disorders include hyper or hypothyroidism, thyroid nodules and thyroid cancers.

Over the last few decades, with the increasing use of sensitive imaging techniques, the proportion of detected thyroid nodules has increased. Consequently, we need to answer several crucial questions: What are the next steps in diagnosis? How and when do we treat those nodules?

This Special Issue “Diagnosis and Management of Thyroid Disorders” aims to promote research that will advance our current knowledge in the field of thyroid disorders. Included papers need to explore diagnostic challenges in thyroid cancers and to present novel techniques in managing thyroid disorders such as radiofrequency ablation, laser ablation or therapeutic procedures like tyrosine kinase inhibitors for advanced malignant disease. 

In this Special Issue, original research articles, reviews and case presentations are welcome.

I am looking forward to receiving your contributions.

Dr. Vladan Zivaljevic
Guest Editor

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 disease management
  • diagnosis of thyroid disease
  • novel procedures
  • thyroid disorders
  • thyroid cancer

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (5 papers)

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Research

10 pages, 255 KiB  
Article
Adiposity Is Associated with a Higher Risk of Thyroid Malignancy in Patients with Hashimoto’s Thyroiditis
by Maria Fokou, Aliki Economides, Elpida Demetriou, Demetris Lamnisos, Aris P. Agouridis, Panagiotis Papageorgis and Panayiotis A. Economides
Diagnostics 2025, 15(7), 853; https://doi.org/10.3390/diagnostics15070853 - 27 Mar 2025
Viewed by 368
Abstract
Background/Objectives: Both adiposity and Hashimoto’s thyroiditis (HT) are states of chronic inflammation. Adiposity may increase the risk of thyroid nodules and thyroid carcinoma. However, its role in patients with HT remains unclear. The connections among thyroid nodularity, adiposity, and HT have not [...] Read more.
Background/Objectives: Both adiposity and Hashimoto’s thyroiditis (HT) are states of chronic inflammation. Adiposity may increase the risk of thyroid nodules and thyroid carcinoma. However, its role in patients with HT remains unclear. The connections among thyroid nodularity, adiposity, and HT have not been explored. Aim: To investigate the impact of adiposity on thyroid nodularity in patients with HΤ and to determine whether there are any differences in the risk for thyroid cancer. Methods: This retrospective cohort study included 294 consecutive patients with HT who were categorized according to their body mass index (BMI). Grayscale ultrasound (US) and fine-needle aspiration (FNA) cytology results were evaluated in association with clinicopathological characteristics. Results: After controlling for age and gender, nodules from patients with a BMI ≥ 25 kg/m2 showed significantly more suspicious or malignant cytology (Thy 4–5) compared to patients with a BMI < 25 kg/m2 (27.03% vs. 18.18%; p < 0.01). Although not statistically significant after adjustments, patients with BMI ≥ 25 kg/m2 demonstrated a higher proportion of nodules classified as highly suspicious on ultrasound (28.20% vs. 22.46%). Additionally, overweight and obese patients tended to have more thyroid nodules (mean ± SD: 2.91 ± 2.11) than normal-weight patients (2.36 ± 1.79), a difference approaching marginal significance (p = 0.06). Conclusions: Adiposity is associated with more suspicious and malignant cytology in patients with HT. Overweight and obese patients with HT tended to have more thyroid nodules. Further studies are needed to investigate the mechanisms linking obesity, thyroid nodules, and HT. Full article
(This article belongs to the Special Issue Diagnosis and Management of Thyroid Disorders)
11 pages, 2095 KiB  
Article
Establishing Reference Values for Thyroid Vascularity Using Ultra-Micro Angiography (UMA) Ultrasound Technology
by Luciana Moisa-Luca, Andreea Bena, Stefania Bunceanu and Dana Stoian
Diagnostics 2025, 15(4), 471; https://doi.org/10.3390/diagnostics15040471 - 14 Feb 2025
Viewed by 498
Abstract
Background/Objectives: Ultra-Micro Angiography (UMA) is an advanced Doppler technique designed to improve the visualization of slow blood flow in small vessels. The Subtraction UMA (sUMA) setting enhances these features by removing background tissue interference, allowing for more precise assessments of microvascularity. This study [...] Read more.
Background/Objectives: Ultra-Micro Angiography (UMA) is an advanced Doppler technique designed to improve the visualization of slow blood flow in small vessels. The Subtraction UMA (sUMA) setting enhances these features by removing background tissue interference, allowing for more precise assessments of microvascularity. This study aims to establish reference values for thyroid vascularity using sUMA technology, providing a foundation for future research in thyroid pathology. Methods: This prospective, single-center study included 106 healthy participants with no evidence of thyroid disease based on biochemical and ultrasound evaluations. All participants underwent multiparametric ultrasound, followed by sUMA to assess thyroid vascularity. The quantitative sUMA measurements were performed using the color pixel percentage (CPP), and three measurements were taken in each thyroid lobe. The median CPP values were calculated and analyzed. Statistical analysis was conducted to evaluate intraobserver reliability and to examine correlations between CPP values and demographic characteristics. Results: The study cohort had a mean age of 41.2 ± 16.3 years, with a predominance of women (82%). CPP sUMA measurements demonstrated excellent feasibility (100%) and intraobserver reliability, with an intraclass correlation coefficient of 0.905 for the right thyroid lobe and 0.897 for the left lobe. The median CPP for the right and left lobes was 26.5% and 27.1%, respectively, with no significant difference between lobes (p = 0.8799). Conclusions: sUMA technology is a reliable and reproducible method for evaluating thyroid microvascularity in healthy individuals. These reference values provide a foundation for future studies investigating thyroid pathology, potentially enhancing the accuracy of diagnostic assessments in clinical practice. Full article
(This article belongs to the Special Issue Diagnosis and Management of Thyroid Disorders)
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21 pages, 273 KiB  
Article
Prospective Voice Assessment After Thyroidectomy Without Recurrent Laryngeal Nerve Injury
by Ivana Šimić Prgomet, Stjepan Frkanec, Ika Gugić Radojković and Drago Prgomet
Diagnostics 2025, 15(1), 37; https://doi.org/10.3390/diagnostics15010037 - 27 Dec 2024
Viewed by 673
Abstract
Background: Thyroidectomy, a surgical procedure for thyroid disorders, is associated with postoperative voice changes, even in cases without recurrent laryngeal nerve (RLN) injury. Our study evaluates the prevalence and predictors of voice disorders in thyroidectomy patients without RLN injury. Methods: Our [...] Read more.
Background: Thyroidectomy, a surgical procedure for thyroid disorders, is associated with postoperative voice changes, even in cases without recurrent laryngeal nerve (RLN) injury. Our study evaluates the prevalence and predictors of voice disorders in thyroidectomy patients without RLN injury. Methods: Our single-center prospective study at the University Hospital Center Zagreb included 243 patients, with pre- and postoperative voice evaluations using acoustic analysis and videostroboscopy. Logistic regression, chi-square, MANOVA, and non-parametric tests assessed the impact of surgical, sociodemographic, and lifestyle factors. Results: The study analyzed 243 participants (141 lobectomy, 102 total thyroidectomy). Postoperative voice disorders occurred in 200 patients (100 lobectomy, 100 total thyroidectomy); 43 (17.7%) experienced no voice disorders. Significant associations were observed for surgery type (χ2 = 29.88, p < 0.001), with total thyroidectomy having higher risk, surgery duration (χ2 = 16.40, p < 0.001), thyroid volume (χ2 = 4.24, p = 0.045), and BMI (χ2 = 8.97, p = 0.011). Gender and age showed no significant correlation. Acoustic parameters differed significantly, with lobectomy patients showing better intensity, jitter, and shimmer values across postoperative measurements. Logistic regression identified surgery type (Exp(B) = 16.533, p = 0.001) and thyroid volume (Exp(B) = 2.335, p = 0.023) as predictors of voice disorders, achieving 82.7% classification accuracy. Multivariate analysis confirmed gender and surgery duration as significant contributors. Surgery duration exceeding 90 min and enlarged thyroid volume negatively influenced outcomes. Significant acoustic differences were also linked to BMI categories, with obese participants exhibiting poorer parameters, particularly shimmer and jitter. Conclusions: Surgery type, thyroid volume, BMI, and surgery duration are most likely significant predictors of postoperative voice disorders. Full article
(This article belongs to the Special Issue Diagnosis and Management of Thyroid Disorders)
14 pages, 2283 KiB  
Article
Cancer Risk in Thyroid Nodules: An Analysis of Over 1000 Consecutive FNA Biopsies Performed in a Single Canadian Institution
by Elsabe J. Smit, Sana Samadi, Mitchell P. Wilson and Gavin Low
Diagnostics 2024, 14(24), 2775; https://doi.org/10.3390/diagnostics14242775 - 10 Dec 2024
Cited by 1 | Viewed by 1722
Abstract
Objective: To determine the cancer risk in thyroid nodules using ACR TI-RADS. Methods: A retrospective analysis of all thyroid biopsies was performed over a 3-year period (2021 to 2023). Variables including gender, age, history of thyroid cancer or neck irradiation, nodule size and [...] Read more.
Objective: To determine the cancer risk in thyroid nodules using ACR TI-RADS. Methods: A retrospective analysis of all thyroid biopsies was performed over a 3-year period (2021 to 2023). Variables including gender, age, history of thyroid cancer or neck irradiation, nodule size and location, TR level, and sonographic features such as punctate echogenic foci (PEF), a very hypoechoic appearance, taller-than-wide shape, and suspected extrathyroidal extension were analyzed. Results: A total of 1140 nodules were assessed in 993 patients, including 740 females (74.5%) and 253 males (25.5%). The mean patient age was 57.1 ± 15.4 years. Variables significantly associated with nodule malignancy included (1) younger age, (2) a prior history of thyroid cancer or neck irradiation, (3) a higher TR level, (4) a taller-than-wide shape in nodules <1 cm, (5) PEF, (6) a very hypoechoic appearance, and (5) suspected extrathyroidal extension (p < 0.05). Gender, nodule location and size were not associated with a higher cancer risk (p > 0.05). Malignancy was found in 40.7% of TR5, 4.8% of TR4, 0.3% of TR3, and 0% of TR1 and 2 nodules. The odds ratios (ORs) for cancer were as follows: TR4 or 5, OR = 19; PEF, OR = 11; a very hypoechoic appearance, OR = 13.3; and suspected extrathyroidal extension, OR = 27.2 (p < 0.01). Conclusions: Higher TR levels, PEF, a very hypoechoic appearance, and suspected extrathyroidal extension are important features for predicting cancer risk. These findings affirm the effectiveness of ACR TI-RADS in nodule risk stratification. Full article
(This article belongs to the Special Issue Diagnosis and Management of Thyroid Disorders)
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9 pages, 539 KiB  
Article
Influence of Anesthesiology Protocol on the Quality of Intraoperative Nerve Monitoring During Thyroid Surgery, One-Year Single Center Experience
by Marina Stojanovic, Milan Jovanovic, Matija Buzejic, Tanja Maravic, Branislav Rovcanin, Nikola Slijepcevic, Katarina Tausanovic and Vladan Zivaljevic
Diagnostics 2024, 14(21), 2351; https://doi.org/10.3390/diagnostics14212351 - 22 Oct 2024
Viewed by 1045
Abstract
Background/Objectives: Anesthesia plays a very important role in the successful management of intraoperative neuromonitoring (IONM). The aim of our study was to investigate the impact of anesthesia induction and maintenance on the quality of signals during surgeries on the thyroid and parathyroid glands [...] Read more.
Background/Objectives: Anesthesia plays a very important role in the successful management of intraoperative neuromonitoring (IONM). The aim of our study was to investigate the impact of anesthesia induction and maintenance on the quality of signals during surgeries on the thyroid and parathyroid glands using neuromonitoring. Methods: The study included 72 patients who underwent surgery with IONM for one year. All the patients were intubated using a Glidescope videolaryngoscope with a hyperangulated blade. Two different approaches were used to facilitate intubation: succinylcholine-1 mg/kg and rocuronium bromide-0.3 mg/kg. For anesthesia maintenance, total intravenous anesthesia (TIVA) or combined anesthesia was used. Patients’ body movements during operations, as well as electromyography signals from the vagus and recurrent laryngeal nerves before resection, were recorded as V1 and R1. Results: Intraoperative unwanted movements were recorded in 25% of patients. Undesired movements were more frequently recorded in the TIVA group compared to the combined anesthesia group (p < 0.001) as well as in patients who received succinylcholine compared to patients who received rocuronium bromide (p = 0.028). Type of anesthesia maintenance as well as type of muscle relaxant did not affect the quality of recorded nerve signals. (p = 0.169 and p = 0.894, respectively). Conclusions: The type of muscle relaxant used significantly affects the occurrence of undesirable movements during thyroid surgery with IONM, while the type of anesthesia maintenance did not influence either the quality of the obtained signal or the occurrence of undesirable movements. Full article
(This article belongs to the Special Issue Diagnosis and Management of Thyroid Disorders)
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