Molecular Testing for Thyroid Nodules and Cancer

Dear Colleagues,

In the last decade, molecular testing for thyroid nodules and cancers has made significant progress and is able to identify thyroid-cancer-related molecular markers which can then be applied clinically for improved decision making in different settings, representing a powerful diagnostic, prognostic, and predictive tool when used judiciously in conjunction with clinical, pathological, and radiological data. The main application of molecular testing is for thyroid nodules with indeterminate cytology (Bethesda III or IV), which represent 10–30% of thyroid nodules. For these indeterminate thyroid nodules, molecular testing is increasingly used in North America to refine the probability of cancer and to help to guide management, including surveillance for nodules that are likely benign or surgery for nodules that are likely malignant. For the latter nodules, molecular testing may also inform the extent of surgical management (lobectomy vs. total thyroidectomy) by predicting the cancer type and risk of cancer recurrence. Similarly, molecular testing may also be considered for thyroid nodules that are suspicious or positive for malignancy on cytology (Bethesda V and VI) if the results are expected to impact the management, including the timing and optimal extent of surgery.  Finally, in patients with advanced thyroid cancer, including anaplastic thyroid carcinoma, molecular testing plays a critical role in identifying potential therapeutic targets allowing for the consideration of neoadjuvant targeted therapy and redefining the role and timing of surgical intervention.

On the other hand, the various molecular testing platforms for thyroid nodules are still costly and not widely available, and data demonstrating a significant clinical impact and supporting their routine use in various clinical settings are still limited.

This Special Issue will include original articles and reviews focusing on key genetic alterations in thyroid nodules and cancers and the application of molecular testing with different platforms in the various clinical settings highlighted above.

We look forward to receiving your contribution.

Dr. Marc Pusztaszeri
Dr. Richard Payne
Guest Editors

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