Advances Of Imaging Techniques In Identifying Malignancy In Thyroid Nodules

Advances of Imaging Techniques in Identifying Malignancy in Thyroid Nodules

Developments in Diagnosis and Management of Thyroid Cancer

Recent advances in knowledge about thyroid cancer show the need for a personalized approach, both for indolent thyroid carcinomas, which can be treated and followed with a more conservative approach, and for advanced thyroid cancer, which may need a more intensive follow-up and aggressive therapy. Several new trends in thyroid cancer approaches rose in the last few years. In particular, thyroid cancer management has been shifting towards a more conservative approach. The focus has been directed to active surveillance in patients with thyroid microcarcinomas, to local conservative non-surgical therapies, such as radiofrequency or alcohol ablation for microcarcinomas and local lymph node metastases, and to minimally invasive surgical techniques. Few data have been reported about these new techniques but they may become the standard of care, particularly for those patients with microcarcinomas with anxiety about active surveillance or for those who present local tumor growth under active surveillance. Furthermore, in the last decades, molecular techniques have opened up new diagnostic scenarios in the pre-intervention identification and risk classification of patients with a known diagnosis of thyroid carcinoma that improved patient management and follow-up. Regarding advanced thyroid tumors, new drugs have been developed to control the disease, such as multi-tyrosine kinase inhibitors and targeted therapies. However, in some cases, tumors become resistant to these drugs. Currently, there are no reliable markers, clinical or molecular, that have been found to be predictive of an early escape from therapy control. Other drugs for this kind of tumor should be developed to be used as second, third, or successive treatment and studies combining two or more drugs are needed to explore the possibility of overcoming the resistance to a single therapy.

Recent Advances in Papillary Thyroid Carcinoma: Diagnosis and Predictive Factors