Past Webinars

Watch prior installments of our online series for thyroid clinicians & researchers. TIROxMDS hosts lectures, journal clubs and tumor boards. Fridays at 8am EST!

Latest Webinar

We are honored to have Dr. Rajam Raghunathan present "Molecular Testing for Indeterminate Thyroid Nodules Past, Present & Future." Dr. Kepal Patel joins as the featured expert discussant. 0:00 Webinar 2:15 Dr. Raghunathan presents 5:00 Molecular Testing Utility Dr. Raghunathan explains molecular diagnostics as crucial for managing indeterminate cytology cases, such as Bethesda III and IV. These diagnostics guide treatment for 30% of U.S. FNA biopsies, reducing unnecessary surgeries and related costs by managing over 90% of benign cases nonoperatively. 8:00 Types & Utility of Molecular Testing Dr. Raghunathan discusses the selection and clinical impact of various molecular tests, stressing their role in pre-operative risk assessment despite histology remaining the definitive standard. 25:22 Dr. Patel presents 32:00 Appropriateness of Molecular Testing Dr. Patel considers molecular testing valuable primarily as a pre-operative adjunct to refine cancer risk assessment, particularly when thyroidectomy decisions are uncertain due to ambiguous clinical, imaging, and cytologic features. 42:39 Discussion with Q&A ** Check out our other programs! ** The THANC Guide https://thancguide.org/ TIRO: Thyroid Int'l Recommendations Online https://tiro.expert/ ** Follow us on Twitter! ** @thancfoundation - https://shorturl.at/puwS0 THANC on FB - https://shorturl.at/svNY4

We are honored to have Dr. Rajam Raghunathan present "Molecular Testing for Indeterminate Thyroid Nodules Past, Present & Future." Dr. Kepal Patel joins as the featured expert discussant.

0:00 Webinar

2:15 Dr. Raghunathan presents

25:22 Dr. Patel presents

42:39 Discussion with Q&A

** Check out our other programs! **

The THANC Guide
https://thancguide.org/

TIRO: Thyroid Int'l Recommendations Online
https://tiro.expert/

** Follow us on Twitter! **
@thancfoundation – https://shorturl.at/puwS0

THANC on FB – https://shorturl.at/svNY4

5 0

YouTube Video UExLSW45d2pxRE1PbTBEQ0xoR1FONzd0blQ0TVBvX1JjZy4wM0EzQkE0MkU3NUQ0QjFG

Molecular Testing for Thyroid Nodules: Past, Present & Future with Dr. Raghunathan

April 26, 2024

We are honored to have Dr. Rajam Raghunathan present "Molecular Testing for Indeterminate Thyroid Nodules Past, Present & Future." Dr. Kepal Patel joins as the featured expert discussant.

0:00 Webinar

2:15 Dr. Raghunathan presents

25:22 Dr. Patel presents

42:39 Discussion with Q&A

** Check out our other programs! **

The THANC Guide
https://thancguide.org/

TIRO: Thyroid Int'l Recommendations Online
https://tiro.expert/

** Follow us on Twitter! **
@thancfoundation – https://shorturl.at/puwS0

THANC on FB – https://shorturl.at/svNY4 …

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    Recent Webinars

    We are honored to have Dr. Rajam Raghunathan present "Molecular Testing for Indeterminate Thyroid Nodules Past, Present & Future." Dr. Kepal Patel joins as the featured expert discussant. 0:00 Webinar 2:15 Dr. Raghunathan presents 5:00 Molecular Testing Utility Dr. Raghunathan explains molecular diagnostics as crucial for managing indeterminate cytology cases, such as Bethesda III and IV. These diagnostics guide treatment for 30% of U.S. FNA biopsies, reducing unnecessary surgeries and related costs by managing over 90% of benign cases nonoperatively. 8:00 Types & Utility of Molecular Testing Dr. Raghunathan discusses the selection and clinical impact of various molecular tests, stressing their role in pre-operative risk assessment despite histology remaining the definitive standard. 25:22 Dr. Patel presents 32:00 Appropriateness of Molecular Testing Dr. Patel considers molecular testing valuable primarily as a pre-operative adjunct to refine cancer risk assessment, particularly when thyroidectomy decisions are uncertain due to ambiguous clinical, imaging, and cytologic features. 42:39 Discussion with Q&A ** Check out our other programs! ** The THANC Guide https://thancguide.org/ TIRO: Thyroid Int'l Recommendations Online https://tiro.expert/ ** Follow us on Twitter! ** @thancfoundation - https://shorturl.at/puwS0 THANC on FB - https://shorturl.at/svNY4

    We are honored to have Dr. Rajam Raghunathan present "Molecular Testing for Indeterminate Thyroid Nodules Past, Present & Future." Dr. Kepal Patel joins as the featured expert discussant.

    0:00 Webinar

    2:15 Dr. Raghunathan presents

    25:22 Dr. Patel presents

    42:39 Discussion with Q&A

    ** Check out our other programs! **

    The THANC Guide
    https://thancguide.org/

    TIRO: Thyroid Int'l Recommendations Online
    https://tiro.expert/

    ** Follow us on Twitter! **
    @thancfoundation – https://shorturl.at/puwS0

    THANC on FB – https://shorturl.at/svNY4

    YouTube Video UExLSW45d2pxRE1PbTBEQ0xoR1FONzd0blQ0TVBvX1JjZy4wM0EzQkE0MkU3NUQ0QjFG

    Molecular Testing for Thyroid Nodules: Past, Present & Future with Dr. Raghunathan

    This session features cases presented by Dr. Lisa Orloff (Stanford). The International Thyroid Tumor Board is moderated by Dr. Michael Tuttle who is joined by our panelists, Drs. Catherine Sinclair, Camilo Gonzalez-Velazquez, Zubair Baloch, Jill Langer, Bruce Culliney and Jeremy Hoang. 0:00 Webinar 2:20 Case 1: Advanced Papillary Thyroid Carcinoma A 45-year-old female with metastatic breast cancer presents with a large papillary thyroid carcinoma, confirmed by biopsy as Bethesda VI. Imaging reveals a dominant nodule and lymph node involvement. Post-total thyroidectomy, pathology confirms a tall cell subtype with BRAF mutation. Radioactive iodine treatment follows, with no follow-up scans available. 33:56 Case 2: Oncocytic Adenoma Identified A 60-year-old female with a suspicious nodule undergoes a right lobectomy. Pathology confirms a 3 cm oncocytic adenoma, with subsequent stable thyroid levels and no further treatment needed. 46:38 Case 3: Complex Thyroid & Parathyroid Carcinoma A 70-year-old with multiple health issues undergoes thyroidectomy and parathyroidectomy for a complex carcinoma with extensive angioinvasion and high mitotic activity. Pathology reveals poorly differentiated carcinoma with vascular and parathyroid invasion, staged as pT3bN1a. ** Check out our other programs! ** The THANC Guide https://thancguide.org/ TIRO: Thyroid Int'l Recommendations Online https://tiro.expert/ ** Follow us on Twitter! ** @thancfoundation - https://shorturl.at/puwS0 THANC on FB - https://shorturl.at/svNY4

    This session features cases presented by Drs. Lisa Orloff (Stanford). The International Thyroid Tumor Board is moderated by Dr. Michael Tuttle who is joined by our panelists, Drs. Catherine Sinclair, Camilo Gonzalez-Velazquez, Zubair Baloch, Jill Langer, Bruce Culliney and Jeremy Hoang.

    0:00 Webinar

    2:25 Case #1

    34:03 Case #2

    46:38 Case #3

    ** Check out our other programs! **

    The THANC Guide
    https://thancguide.org/

    TIRO: Thyroid Int'l Recommendations Online
    https://tiro.expert/

    ** Follow us on Twitter! **
    @thancfoundation – https://shorturl.at/puwS0

    THANC on FB – https://shorturl.at/svNY4

    YouTube Video UExLSW45d2pxRE1PbTBEQ0xoR1FONzd0blQ0TVBvX1JjZy5GQkE1RUQxMTA5RkRDNDZB

    Int'l Thyroid Tumor Board w/ Dr. Mike Tuttle (Apr 2024)

    We are honored to have Dr. Seza Gulec present "A Joint Statement from the ATA, the European Association of Nuclear Medicine, the European Thyroid Association, the Society of Nuclear Medicine and Molecular Imaging on Current Diagnostic and Theranostic Approaches in the Management of Thyroid Cancer." Dr. Marcin Barczynski joins as the featured expert discussant. Our sincere gratitude to Dr. Munir Ghesani, our special guest moderator this week. 0:00 Webinar 2:47 Dr. Gulec presents 2:47 Theranostic Approaches In Thyroid Cancer Dr. Gulec introduces the "Martinique Initiative," a framework led by top thyroid cancer leaders to discuss controversial topics and foster evidence-based discussions. This initiative results in the "Martinique Principles," guiding the use of Radioactive Iodine (I-131) in thyroid cancer management and providing insights into its optimal therapeutic use. 7:50 Peri-Operative Risk Stratification In Thyroid Cancer Dr. Gulec explores the "Martinique Principles" using a three-pronged approach focusing on risk classification in operative settings. He discusses survival and recurrence probabilities based on American Thyroid Association and American Joint Committee on Cancer guidelines. He proposes molecular theranostics as a tool for evaluating surgical roles in cancer management, emphasizing its utility in detecting critical genes and informing diagnosis, monitoring, and treatment decisions. 33:45 Diagnostic RAI Imaging In Initial Staging Dr. Gulec discusses the need for improved sensitivity in imaging techniques due to evidence that pre-ablation diagnostic Radioactive Iodine (RAI) imaging is not fully effective, particularly in BRAF-like tumors with small nodal metastases. He highlights the risks of misinterpreting focal remnants as nodal disease, which can lead to incorrect upstaging in thyroid cancer risk categories. 43:15 Dr. Barczynski presents 49:00 Surgical Management & Risk Stratification Dr. Barczynski argues for integrating risk stratification into surgical treatment strategies for thyroid cancer. He emphasizes collaboration between American and European Thyroid Associations and the Society of Nuclear Medicine and Molecular Imaging, advocating for expanded use of molecular theranostics in initial patient management. 52:01 Discussion with Q&A ** Check out our other programs! ** The THANC Guide https://thancguide.org/ TIRO: Thyroid Int'l Recommendations Online https://tiro.expert/ ** Follow us on Twitter! ** @thancfoundation - https://shorturl.at/puwS0 THANC on FB - https://shorturl.at/svNY4

    We are honored to have Dr. Seza Gulec present "A Joint Statement from the ATA, the European Association of Nuclear Medicine, the European Thyroid Association, the Society of Nuclear Medicine and Molecular Imaging on Current Diagnostic and Theranostic Approaches in the Management of Thyroid Cancer." Dr. Marcin Barczynski joins as the featured expert discussant. Our sincere gratitude to Dr. Munir Ghesani, our special guest moderator this week.

    0:00 Webinar

    2:47 Dr. Gulec presents

    43:15 Dr. Barczynski presents

    52:01 Discussion with Q&A

    ** Check out our other programs! **

    The THANC Guide
    https://thancguide.org/

    TIRO: Thyroid Int'l Recommendations Online
    https://tiro.expert/

    ** Follow us on Twitter! **
    @thancfoundation – https://shorturl.at/puwS0

    THANC on FB – https://shorturl.at/svNY4

    YouTube Video UExLSW45d2pxRE1PbTBEQ0xoR1FONzd0blQ0TVBvX1JjZy4wQ0ZGQjRENTMyMzJBNzUz

    New Thyroid Cancer Diagnostics & Theranostic Approaches with Dr. Gulec

    We are honored to have Dr. Hernán González present "ThyroidPrint®: Clinical Utility for Indeterminate Thyroid Cytology." Dr. Michael Via joins as the featured expert discussant. 0:00 Webinar 2:22 Dr. González presents 3:00 Gene Discovery & Molecular Testing Parameters The development of ThyroidPrint aimed to improve decision-making for patients with indeterminate thyroid nodules, focusing on Bethesda categories III and IV. By analyzing 18 genes from 253 biopsies with qPCR and employing machine learning techniques, the research narrowed down to 10 genes, achieving 93% sensitivity and 81% specificity. This was part of an effort to differentiate benign from malignant nodules more effectively. 8:00 Prototype Biomarkers for ThyroidPrint Dr. Gonzalez's team utilized 136 indeterminate Bethesda III IV FNA samples, compared against gold-standard surgical biopsies, to identify crucial gene signatures. These included epithelial and inflammatory biomarkers, as well as tumor microenvironment signatures like chemokines, demonstrating high sensitivity, specificity, and predictive value. 9:40 Clinical Validation & Utility ThyroidPrint A prospective, multicenter, double-blinded study across diverse ethnic groups in the US and Chile confirmed the clinical validity of ThyroidPrint. The test's specificity and sensitivity rates were high enough for practical clinical use. In particular, it proved effective for Bethesda III and IV nodules, reducing unnecessary surgeries and accurately identifying malignancy, offering significant benefits, especially for patients at intermediate risk of overtreatment. 21:32 Dr. Via presents 28:00 Utility of Molecular Marker Testing Dr. Via highlighted the supplemental role of molecular marker testing in clinical judgment and malignancy risk assessment, according to 2015 ATA guidelines. Despite the higher cost of molecular testing compared to diagnostic lobectomy, its greater diagnostic accuracy offers a higher overall value, emphasizing its utility in clinical practice. 40:08 Discussion with Q&A ** Check out our other programs! ** The THANC Guide https://thancguide.org/ TIRO: Thyroid Int'l Recommendations Online https://tiro.expert/ ** Follow us on Twitter! ** @thancfoundation - https://shorturl.at/puwS0 THANC on FB - https://shorturl.at/svNY4

    We are honored to have Dr. Hernán González present "ThyroidPrint®: Clinical Utility for Indeterminate Thyroid Cytology." Dr. Michael Via joins as the featured expert discussant.

    0:00 Webinar

    2:22 Dr. González presents

    21:32 Dr. Via presents

    40:08 Discussion with Q&A

    ** Check out our other programs! **

    The THANC Guide
    https://thancguide.org/

    TIRO: Thyroid Int'l Recommendations Online
    https://tiro.expert/

    ** Follow us on Twitter! **
    @thancfoundation – https://shorturl.at/puwS0

    THANC on FB – https://shorturl.at/svNY4

    YouTube Video UExLSW45d2pxRE1PbTBEQ0xoR1FONzd0blQ0TVBvX1JjZy40MkE4OTk2MUZBMEQ4NEFE

    ThyroidPrint®: A Clinical Utility for Indeterminate Thyroid Cytology with Dr. González

    We are honored to have Dr. Ramona Dadu present "Surgery After BRAF Directed Therapy is Associated With Improved Survival in BRAFV600E Mutant Anaplastic Thyroid Cancer: A Single Center Retrospective Cohort Study." Dr. Michael Xing joins as the featured expert discussant. 0:00 Webinar 3:21 Dr. Dadu presents 4:04 Progress in Anaplastic Thyroid Carcinoma Dr. Dadu introduces the progression of anaplastic thyroid carcinoma (ATC) over ten years, highlighting the historical survival patterns of patients. There have been significant survival improvements for ATC patients recently, attributed to new treatment standards, notably BRAF-targeted therapies. 7:10 How Molecular Genetics Impacts Treatment Dr. Dadu discusses the genesis of ATC from genetic abnormalities, with a 45% frequency of the BRAF mutation in such cancers. Other genetic factors like RAS, TP53, TERTp, and PIK3CA mutations also play crucial roles. This understanding has paved the way for molecular targeted therapies, enhancing the effectiveness of traditional treatments. Clinical trial summaries and a study on the survival benefits of neoadjuvant BRAF-directed therapy prior to surgery are mentioned, showing significant improvements in survival rates. 23:21 Dr. Xing presents 26:20 The BRAF Oncogenic Pathway in Thyroid Cancer Dr. Xing reviews the role of the BRAF mutation in thyroid cancer, including its prevalence and clinical effects. The mutation's impact on various thyroid cancer types, such as papillary, follicular, anaplastic, and medullary thyroid carcinoma, is detailed. 41:50 The Other Troublemaker in Thyroid Cancer Dr. Xing focuses on TERT promoter mutations as another significant genetic factor adversely affecting thyroid cancer prognosis. The coexistence and biological significance of TERT and BRAF V600E mutations are discussed, showing the worst clinical outcomes when these mutations are present together. A molecular mechanism involving the FOS-GABP pathway for TERT activation is explained. 52:20 The Relationship of BRAF & TERT Mutations Dr. Xing emphasizes the necessity of considering BRAF and TERT mutations together for understanding and treating thyroid carcinomas effectively. This approach is vital for developing optimal targeted treatment strategies. 61:01 Discussion with Q&A ** Check out our other programs! ** The THANC Guide https://thancguide.org/ TIRO: Thyroid Int'l Recommendations Online https://tiro.expert/ ** Follow us on Twitter! ** @thancfoundation - https://shorturl.at/puwS0 THANC on FB - https://shorturl.at/svNY4

    We are honored to have Dr. Ramona Dadu present "Surgery After BRAF Directed Therapy is Associated With Improved Survival in BRAFV600E Mutant Anaplastic Thyroid Cancer: A Single Center Retrospective Cohort Study." Dr. Michael Xing joins as the featured expert discussant.

    0:00 Webinar

    3:21 Dr. Dadu presents

    23:21 Dr. Xing presents

    61:01 Discussion with Q&A

    ** Check out our other programs! **

    The THANC Guide
    https://thancguide.org/

    TIRO: Thyroid Int'l Recommendations Online
    https://tiro.expert/

    ** Follow us on Twitter! **
    @thancfoundation – https://shorturl.at/puwS0

    THANC on FB – https://shorturl.at/svNY4

    YouTube Video UExLSW45d2pxRE1PbTBEQ0xoR1FONzd0blQ0TVBvX1JjZy4zNEM4RkZDQUU4MEYwQzJE

    Surgery & Improved Survival in BRAFV600E Thyroid Cancer with Dr. Dadu

    This session features cases presented by Drs. Carrie Cunningham, Lori Wirth and Erik Alexander. The International Thyroid Tumor Board is moderated by Dr. Michael Tuttle who is joined by our panelists, Drs. Janice Pasieka, Eyal Robenshtok, Margaret Brandwein-Weber, Jill Langer, Kate Newbold and Munir Ghesani. 0:00 Webinar 0:33 In Memoriam 6:50 Introductions 8:58 Case #1 Presented by Dr. Alexander An 18-year-old healthy female discovered a thyroid nodule during a routine check-up, with no familial thyroid issues. An ultrasound revealed four nodules, 10-15 mm in size, classified as TIRAD 3-4, but no abnormal lymph nodes were detected. This case raised discussions on the applicability of TIRAD in pediatric populations. Notably, younger patients have a significantly higher risk (30%) of malignancy compared to older adults (5%), pointing to distinct mutational profiles and disease patterns in pediatric versus adult thyroid cancers. Fine Needle Aspiration confirmed the diagnosis of Papillary Thyroid Carcinoma, which upon surgery was identified as Cribriform Morular Thyroid Carcinoma. Treatment paralleled that of conventional PTC, omitting radioiodine and emphasizing thyroglobulin monitoring, with genetic testing revealing a positive APC mutation. 25:42 Case #2 Presented by Dr. Cunningham A 56-year-old woman with health concerns including weight gain, hypertension, hypothyroidism, and diabetes (medicated with Ozempic) reported a palpable thyroid nodule. Diagnostic imaging identified TR3 and TR4 nodules in her right and left thyroid lobes, respectively, with genetic testing raising suspicion for Medullary Thyroid Carcinoma (MTC). Laboratory tests showed significantly high calcitonin (547) and CEA (32) levels, along with slightly elevated PTH. She underwent total thyroidectomy and bilateral central lymph node dissection, where 22 lymph nodes were removed, and 3 exhibited involvement, including extranodal extension (ENE). Discussions centered on Fine Needle Aspiration's (FNA) approximately 50% diagnostic accuracy for MTC and considered widespread calcitonin testing as a more precise evaluation method. 45:06 Case #3 Presented by Dr. Wirth A 27-year-old woman with stage IVb sporadic Medullary Thyroid Carcinoma (MTC) underwent initial thyroidectomy and neck dissection, with a postoperative calcitonin level of 181. Despite experiencing recurrent neck masses and undergoing revision surgery, the disease progressed without distant metastasis, leading to treatment with Cabozantinib, followed by Selpercatinib due to further progression. The treatment with Selpercatinib resulted in significant disease regression and biomarker reduction, highlighting the effectiveness of RET-targeted therapies in RET-positive MTC cases. ** Check out our other programs! ** The THANC Guide https://thancguide.org/ TIRO: Thyroid Int'l Recommendations Online https://tiro.expert/ ** Follow us on Twitter! ** @thancfoundation - https://shorturl.at/puwS0 THANC on FB - https://shorturl.at/svNY4

    This session features cases presented by Drs. Carrie Cunningham, Lori Wirth and Erik Alexander. The International Thyroid Tumor Board is moderated by Dr. Michael Tuttle who is joined by our panelists, Drs. Janice Pasieka, Eyal Robenshtok, Margaret Brandwein-Weber, Jill Langer, Kate Newbold and Munir Ghesani.

    0:00 Webinar

    0:33 In Memoriam

    6:50 Introductions

    8:58 Case #1

    25:42 Case #2

    45:06 Case #3

    ** Check out our other programs! **

    The THANC Guide
    https://thancguide.org/

    TIRO: Thyroid Int'l Recommendations Online
    https://tiro.expert/

    ** Follow us on Twitter! **
    @thancfoundation – https://shorturl.at/puwS0

    THANC on FB – https://shorturl.at/svNY4

    YouTube Video UExLSW45d2pxRE1PbTBEQ0xoR1FONzd0blQ0TVBvX1JjZy5CNDEwQURGQjkwNDIzRUYw

    Int'l Thyroid Tumor Board w/ Dr. Mike Tuttle (Mar 2024)

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    Every Friday at 8am EST, we host an educational webinar presentation. The TIROxMDS series includes journal clubs, lectures and tumor boards where a medical professional or panel of experts will present their recent findings followed by a Q&A discussion.

    TIROxMDS highlights articles and case presentations from the fields of endocrinology, surgery, pathology and nuclear medicine. If you are interested in joining a webinar, receiving updates and news, we invite you to subscribe.

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    Upcoming Webinars

    Rajam Raghunathan, MD

    Guest Presenter

    Journal Club

    Molecular Testing for Indeterminate Thyroid Nodules Past, Present & Future

    Apr. 26, 2024

    Mark L. Urken, MD

    Moderator

    Panel Discussion

    History of Thyroid Surgery in the Last Century

    May 3, 2024

    RSVP

    Aime Franco, MD

    Guest Presenter

    Journal Club

    Survivorship, Quality of Life, and Transition to Adult Care for Pediatric and Adolescent Thyroid Cancer Survivors

    May 10, 2024

    RSVP