Teodoriu Laura, Leustean Letitia, Ungureanu Maria-Christina, Bilha Stefana, Grierosu Irena, Matei Mioara, Preda Cristina, Stefanescu Cipriana
Endocrinology Department, "Grigore T. Popa" University of Medicine and Pharmacy, 700111 Iasi, Romania.
Biophysics and Medical Physics-Nuclear Medicine Department, "Grigore T. Popa" University of Medicine and Pharmacy, 700111 Iasi, Romania.
Diagnostics (Basel). 2022 Apr 10;12(4):944. doi: 10.3390/diagnostics12040944.
Personalized diagnosis can save unnecessary thyroid surgeries, in cases of indeterminate thyroid nodules, when clinicians tend to aggressively treat all these patients. Personalized diagnosis benefits from a combination of imagery and molecular biomarkers, as well as artificial intelligence algorithms, which are used more and more in our timeline. Functional imaging diagnosis such as SPECT, PET, or fused images (SPECT/CT, PET/CT, PET/MRI), is exploited at maximum in thyroid nodules, with a long history in the past and a bright future with many suitable radiotracers that could properly contribute to diagnosing malignancy in thyroid nodules. In this way, patients will be spared surgery complications, and apparently more expensive diagnostic workouts will financially compensate each patient and also the healthcare system. In this review we will summarize essential available diagnostic tools for malignant and benignant thyroid nodules, beginning with functional imaging, molecular analysis, and combinations of these two and other future strategies, including AI or NIS targeted gene therapy for thyroid carcinoma diagnosis and treatment as well.
在甲状腺结节性质不确定的情况下，当临床医生倾向于对所有这些患者进行积极治疗时，个性化诊断可以避免不必要的甲状腺手术。个性化诊断受益于影像学和分子生物标志物的结合，以及人工智能算法，在我们这个时代，这些技术的应用越来越广泛。诸如单光子发射计算机断层扫描（SPECT）、正电子发射断层扫描（PET）或融合图像（SPECT/CT、PET/CT、PET/MRI）等功能成像诊断在甲状腺结节中得到了最大程度的应用，其在过去有着悠久的历史，并且随着许多合适的放射性示踪剂的出现，在未来有着光明的前景，这些示踪剂能够为诊断甲状腺结节的恶性病变提供有力帮助。通过这种方式，患者将避免手术并发症，而且显然更为昂贵的诊断检查在经济上会对每个患者以及医疗系统都有所补偿。在本综述中，我们将总结用于诊断甲状腺良恶性结节的基本可用工具，首先从功能成像、分子分析以及这两者的结合和其他未来策略开始，其中还包括用于甲状腺癌诊断和治疗的人工智能或钠碘同向转运体（NIS）靶向基因治疗。
