Precision Medicine in Differentiated Thyroid Carcinoma (DTC): Integrating Molecular Profiling, Advanced Imaging, and Tailored Theranostics

Differentiated Thyroid Carcinoma (DTC) is the most common form of thyroid cancer, accounting for over 90% of all thyroid malignancies. It originates from the follicular cells of the thyroid gland, which are responsible for producing thyroid hormones and trapping iodine. DTC is generally characterized by a slow growth rate and an excellent prognosis, with 10-year survival rates exceeding 90-95% for most patients. However, a significant subset of patients develops refractory disease, characterized by radioactive iodine (RAI) resistance (RAI-R DTC), leading to a drastic reduction in 10-year survival rates. The management of DTC is currently shifting from a "one-size-fits-all" approach toward a precision personalized medicine framework.This Special Issue aims to consolidate the latest advancements in the molecular landscape, diagnostic imaging, and therapeutic innovations that are redefining the management of DTC. We seek to bridge the gap between basic genomic research and clinical application, focusing on how molecular signatures (such as BRAF, RAS, and TERT promoter mutations) can be utilized to risk-stratify patients and guide surgical and adjuvant interventions. The recent updates in the ATA (American Thyroid Association) and ETA (European Thyroid Association) guidelines emphasize the need for individualized care. Furthermore, the rapid approval of several targeted therapies for advanced thyroid cancer has created a "knowledge gap" regarding the optimal sequence of treatment. By bringing together experts from nuclear medicine, endocrinology, surgery, and oncology, this Special Issue will provide a multidisciplinary roadmap for the next decade of thyroid cancer care.Themes of interest include, but are not limited to:- The Impact of Molecular Testing (likeBRAF V600E, TERT promoter, and RET ) on therapeutic decisions- The "Non-Iodine Avid" Challenge: Advanced PET imaging with [¹⁸F]FDG, [⁶⁸Ga]Ga-PSMA, and [⁶⁸Ga]Ga-FAPI for detecting occult metastases in patients with elevated thyroglobulin and negative iodine scans.- Redifferentiation Protocols: Using targeted inhibitors (e.g., Trametinib, Dabrafenib) to "re-sensitize" RAI-R tumors to radioactive iodine treatment.- Novel Theranostic radiopharmaceuticasl.- Artificial Intelligence in DTC: The use of radiomics and machine learning to predict treatment response from baseline ultrasound or PET/CT scans.- Multidisciplinary Management of DTC patients Topic editors: Domenico Albano, Cristina Alina Silaghi Source: https://www.frontiersin.org/research-topics/81809/precision-medicine-in-differentiated-thyroid-carcinoma-dtc-integrating-molecular-profiling-advanced-imaging-and-tailored-theranostics