A Prospective Study on Challenges in the Management of Indeterminate Thyroid Nodules Without Molecular Testing.

@article{riju2026prospective,
  title = {{A Prospective Study on Challenges in the Management of Indeterminate Thyroid Nodules Without Molecular Testing.}},
  author = {Jeyashanth Riju and Nihal Thomas and V Thomas Paul and Deepak Thomas Abraham and M Paul Jacob and J Anne Prabhu and Marie Therese and Remya Rajan and J Anish Cherian and Shawn Thomas and Rekha Pai and C Rajiv Michael and J Amit Tirkey and Natarajan Ramlingam and Elanthenral Sigamani and H S Asha and Nitin Kapoor and Felix Jebasingh and M Gnanasekaran and A Reetu John and P G Maya},
  journal = {International journal of endocrinology},
  year = {2026},
  month = oct,
  doi = {10.1155/ije/4705557},
  url = {https://europepmc.org/article/MED/42959343},
  note = {CC BY},
}

TY  - JOUR
TI  - A Prospective Study on Challenges in the Management of Indeterminate Thyroid Nodules Without Molecular Testing.
AU  - Jeyashanth Riju
AU  - Nihal Thomas
AU  - V Thomas Paul
AU  - Deepak Thomas Abraham
AU  - M Paul Jacob
AU  - J Anne Prabhu
AU  - Marie Therese
AU  - Remya Rajan
AU  - J Anish Cherian
AU  - Shawn Thomas
AU  - Rekha Pai
AU  - C Rajiv Michael
AU  - J Amit Tirkey
AU  - Natarajan Ramlingam
AU  - Elanthenral Sigamani
AU  - H S Asha
AU  - Nitin Kapoor
AU  - Felix Jebasingh
AU  - M Gnanasekaran
AU  - A Reetu John
AU  - P G Maya
PY  - 2026
DA  - 2026/10/28
JO  - International journal of endocrinology
DO  - 10.1155/ije/4705557
UR  - https://europepmc.org/article/MED/42959343
AB  - Introduction  Treating indeterminate thyroid nodules (ITNs) without validated molecular testing (MT) has been challenging. However, adding specific clinical and radiological parameters helps us to decide on treatment for a few individuals. The risk of malignancy in ITN after eliminating the obvious risk parameters needs to be studied.Methods  This prospective single-centre analysis included patients who underwent fine needle aspiration cytology (FNAC) of thyroid between March 2022 and October 2023. The study included patients with thyroid nodules classified as Bethesda III/IV who subsequently underwent surgery. Different clinicopathological and FNAC-related parameters were statistically analysed to predict malignancy, after excluding those factors that would strongly suggest malignancy.Results  Among 1501 patients who underwent FNAC, 207 met the inclusion criteria. The mean age of the study population was 39 ± 12.1 years, and the majority were women (80.2%). Among the ITNs, 86% were Bethesda III, and 14% were Bethesda IV nodules. The risk of malignancy in Bethesda III and IV nodules was 67.4% and 69%, respectively. On multivariate analysis, it was noted that hypothyroidism was the single independent factor that predicted malignancy associated with a significant odds of 0.309 (95%CI:0.127-0.784, p = 0.013). The most common malignancy among ITNs was the follicular variant of papillary thyroid carcinoma.Conclusion  Women less than 40 years of age, in this cohort, had a higher risk of malignancy compared to the Western population. More than half of the patients diagnosed with ITN underwent surgery. Hypothyroidism is an independent factor that may predict the risk of malignancy in ITNs, and this needs external validation. Rule-in MT might be important in categorizing patients with ITN in the Indian population.
SN  - 1687-8337
SN  - 1687-8345
ER  -