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Pedro Weslley Rosario Santa Casa de Belo Horizonte, Minas Gerais, Brazil

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Tiara Grossi Rocha Santa Casa de Belo Horizonte, Minas Gerais, Brazil

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Gabriela Franco Mourão Santa Casa de Belo Horizonte, Minas Gerais, Brazil

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et al. 2014 ), and TIR3 of the Italian Reporting System ( Pacini et al. 2018 ) are defined as ‘indeterminatecytology ( Table 1 ). This result corresponds to approximately 10–25% of all FNAs ( Gharib et al. 2016 , Pacini et al. 2018

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Carla Colombo Division of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

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Marina Muzza Laboratory of Endocrine and Metabolic Research, Istituto Auxologico Italiano IRCCS, Milan, Italy

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Gabriele Pogliaghi Laboratory of Endocrine and Metabolic Research, Istituto Auxologico Italiano IRCCS, Milan, Italy

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Sonia Palazzo Pathology Unit, Istituto Auxologico Italiano IRCCS, Milan, Italy

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Guia Vannucchi Division of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy

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Leonardo Vicentini Endocrine Surgery Unit, Istituto Auxologico Italiano IRCCS, Milan, Italy

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Luca Persani Division of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy
Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy

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Giacomo Gazzano Pathology Unit, Istituto Auxologico Italiano IRCCS, Milan, Italy

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Laura Fugazzola Division of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

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and histological data, and risk score of the 65 patients with indeterminate cytology submitted to surgery. Molecular data were obtained by means of the PTC-MA assay ( Nikiforova et al . 2018 , Colombo et al . 2019 ). Patient ID Gender

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Pedro Weslley Rosario Santa Casa de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil

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Dear Editor, We thank Qichang and Bin for the comments regarding our review ‘Usefulness of accessible imaging methods in thyroid nodules with indeterminate cytology’ ( Rosário et al . 2021 ), published in this issue of Endocrine

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Pablo Valderrabano Department of Head and Neck-Endocrine Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA

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Laila Khazai Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA

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Marino E Leon Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA

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Zachary J Thompson Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA

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Zhenjun Ma Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA

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Christine H Chung Department of Head and Neck-Endocrine Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA

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Julie E Hallanger-Johnson Department of Head and Neck-Endocrine Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA

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Kristen J Otto Department of Head and Neck-Endocrine Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA

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Kara D Rogers Department of Head and Neck-Endocrine Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA

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Barbara A Centeno Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA

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Bryan McIver Department of Head and Neck-Endocrine Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA

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Introduction Several molecular marker tests are available to refine the diagnosis of thyroid nodules with indeterminate cytology. Initially, these tests were classified as either ‘rule-in’ or ‘rule-out’ tests, depending on their ability to

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Qi-Chang Wan Department of Nuclear Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

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Bin Ji Department of Nuclear Medicine, China-Japan Union Hospital of Jilin University, Changchun, China

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of thyroid nodules with indeterminate cytology (TNIC) ( Rosario et al. 2021 ). For 18 F-FDG-PET, it was stated that ‘a nodule characterized by low or absent 18 F-FDG uptake is considered at a very low risk of malignance’, and ‘thyroidectomy can be

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Tanner Freeman Department of Pathology, UPMC, Pittsburgh, Pennsylvania, USA

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Charit Taneja Division of Endocrinology and Metabolism, UPMC, Pittsburgh, Pennsylvania, USA

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N Paul Ohori Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

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Abigail I Wald Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

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John Skaugen Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

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Linwah Yip Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

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Seungwon Kim Department of Otolaryngology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

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Robert L Ferris Department of Otolaryngology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
UPMC Hillman Cancer Center, Department of Oncology, Pittsburgh, Pennsylvania, USA

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Marina N Nikiforova Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

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Somak Roy Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

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Yuri E Nikiforov Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

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2018 ). This association raises the possibility of utilizing molecular markers to detect RCC metastatic to distant sites. ThyroSeq ® version 3 (v3), a targeted next-generation sequencing (NGS) test used for thyroid nodules with indeterminate cytology

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Pedro Weslley Rosario Santa Casa de Belo Horizonte, Minas Gerais, Brazil

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Gabriela Franco Mourão Santa Casa de Belo Horizonte, Minas Gerais, Brazil

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Maurício Buzelin Nunes Santa Casa de Belo Horizonte, Minas Gerais, Brazil

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Marcelo Saldanha Nunes Santa Casa de Belo Horizonte, Minas Gerais, Brazil

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Maria Regina Calsolari Santa Casa de Belo Horizonte, Minas Gerais, Brazil

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et al . 2016 ) was common in NIFTP, while a highly suspicious appearance was rarely observed ( Table 1 ). NIFTP more frequently exhibited indeterminate cytology (Bethesda categories iii or iv) (62%), while malignant cytology was uncommon (4%) ( Table

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Sergio Vargas-Salas Department of Surgical Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile , Santiago, Chile

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José R Martínez Department of Surgical Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile , Santiago, Chile

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Soledad Urra Department of Surgical Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile , Santiago, Chile

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José Miguel Domínguez Department of Endocrinology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile

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Natalia Mena GeneproDX, Santiago, Chile

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Thomas Uslar Department of Internal Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile

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Marcela Lagos Department of Clinical Laboratories, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile

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Marcela Henríquez Department of Clinical Laboratories, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile

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Hernán E González Department of Surgical Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile , Santiago, Chile

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ZW Cibas ES Chudova D Diggans J Friedman L Kloos RT LiVolsi VA Mandel SJ , 2012 Preoperative diagnosis of benign thyroid nodules with indeterminate cytology . New England Journal of Medicine 367 705 – 715 . ( https://doi.org/10.1056/NEJMoa

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Arivarasan Karunamurthy Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

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Federica Panebianco Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

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Susan J Hsiao Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

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Jennie Vorhauer Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

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Marina N Nikiforova Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

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Simion Chiosea Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

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Yuri E Nikiforov Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

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samples is placed in indeterminate cytological category, preventing optimal patient management (Haugen et al. 2016). Advances in sequencing technology coupled with better understanding of the molecular mechanisms of thyroid tumorigenesis have led to

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Alyaksandr V Nikitski Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

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Marina N Nikiforova Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

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Linwah Yip Division of Endocrine Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

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Esra Karslioglu-French Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

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Sally E Carty Division of Endocrine Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

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Yuri E Nikiforov Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

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routinely on FNA samples with indeterminate cytology and on selected surgical pathology samples as part of clinical care. Available de-identified demographic, clinical, and pathologic data were extracted from the database. Molecular analysis ThyroSeq

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