TI-RADS & thyroid cancer guidelines
ACR TI-RADS: White Paper of the ACR TI-RADS Committee
Tessler & Middleton · J Am Coll Radiol · 2017
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2025 ATA Management Guidelines for Adult Patients with Differentiated Thyroid Cancer
Ringel et al. · Thyroid · 2025
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Thyroid Nodule Tools — TI-RADS Calculator & Volume Tracker
Interactive tools · drmichelakos.com
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RLN reconstruction & monitoring
RLN reconstruction — immediate reinnervation at the time of thyroid cancer resection:
Selective vagus-RLN anastomosis in thyroidectomy with cancer invasion or iatrogenic transection
Yuan & Wu · Langenbecks Arch Surg · 2020
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Preoperative Lugol's solution for Graves': decreases vascularity and blood loss; may decrease hypoparathyroidism and nerve injury rates.
Preoperative iodine in thyroidectomy for hyperthyroidism — meta-analysis: decreased blood loss but not complications
Tsai et al. · Otolaryngol Head Neck Surg · 2019
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RLN monitoring studies:
RCT: visualization vs. neuromonitoring of RLN during thyroidectomy (N≈1,000)
Barczyński et al. · Br J Surg · 2009
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IONM vs. visualisation alone — meta-analysis of RCTs (N≈5,000 nerves at risk)
Davey et al. · Am J Surg · 2022
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Surgical approaches in medullary thyroid cancer
Neoadjuvant selective RET inhibitor (selpercatinib) for medullary thyroid cancer — emerging data from case series and ongoing trials:
Neoadjuvant therapy in thyroid cancer: impact of multikinase and selective inhibitors
Califano, Randolph & Pitoia · Endocr Relat Cancer · 2025
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State of the art and future directions in systemic treatment of MTC — including neoadjuvant selpercatinib
Jager et al. · Curr Opin Oncol · 2022
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Japanese approach to MTC: lobectomy with central and lateral dissection is permitted for sporadic, non-RET disease in select patients:
Japanese Thyroid Association guidelines — medullary thyroid carcinoma
Japanese Thyroid Association
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Parathyroid intraoperative visualization & imaging
Emerging imaging technologies for parathyroid identification in thyroid surgery — NIRAF review (AHNS)
Silver Karcioglu, Bergenfelz et al. · JAMA Otolaryngol · 2023
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Preoperative imaging techniques in primary hyperparathyroidism — review
Bunch & Kelly · JAMA Otolaryngol · 2018
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18F-fluorocholine PET/CT as first-line imaging in primary hyperparathyroidism
Broos et al. · EJNMMI Res · 2019
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Parathyroid FNA with iPTH washout concentration in primary hyperparathyroidism
Obołończyk et al. · Biomedicines · 2022
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Percutaneous ablation of parathyroid adenomas
Evidence synthesis across 33 publications (n > 2,900 patients). RFA achieves 90.1% cure in PHPT with a permanent hoarseness rate of 0.21% — comparable to parathyroidectomy at 12 months, with 4× less hypocalcemia and no incision. Pooled major complication rate <0.5% across all techniques.
Percutaneous ablation of parathyroid adenomas — evidence synthesis
Sim, Michelakos · 2026 · 33 source publications · 3 meta-analyses · 1 systematic review · 22 primary cohort studies
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Bilateral adrenalectomy for congenital adrenal hyperplasia
Review and meta-analysis
MacKay, 2018
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Variant adrenal vein anatomy occurs in 13% of laparoscopic adrenalectomies.
Variant adrenal vein anatomy: 13% of laparoscopic adrenalectomies
Scholten, 2013
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Adrenergic receptors & alpha-blocker comparison
Adrenergic receptor subtypes, locations, and pharmacology:
| Adrenergic Receptor | Location | Effects of Receptor Agonism | Receptor Agonists | Receptor Antagonists |
|---|---|---|---|---|
| Alpha-1 (α1) | Vascular smooth muscle, eyes, bladder, prostate | Vasoconstriction, pupil dilation (mydriasis), bladder contraction, increased peripheral resistance | Phenylephrine, Norepinephrine | Prazosin, Doxazosin, Terazosin |
| Alpha-2 (α2) | Presynaptic nerve terminals, pancreas, platelets | Decreased norepinephrine release, decreased insulin release, platelet aggregation | Clonidine, Methyldopa | Yohimbine, Phentolamine |
| Beta-1 (β1) | Heart (SA node, AV node), kidneys | Increased heart rate, increased contractility, increased renin release | Dobutamine, Isoproterenol, Epinephrine | Metoprolol, Atenolol, Bisoprolol |
| Beta-2 (β2) | Bronchial smooth muscle, skeletal muscle vessels, liver, uterus | Bronchodilation, vasodilation, glycogenolysis, uterine relaxation | Albuterol, Terbutaline, Salmeterol | Propranolol, Labetalol |
| Beta-3 (β3) | Adipose tissue, bladder | Lipolysis, bladder relaxation (detrusor muscle) | Mirabegron | N/A |
Alpha-blocker comparison for preoperative pheochromocytoma preparation:
| Feature | Doxazosin | Phenoxybenzamine |
|---|---|---|
| Class | Selective α1-adrenergic antagonist | Non-selective irreversible α1 and α2 adrenergic antagonist |
| Receptor Selectivity | Selective for α1 receptors | Non-selective (blocks both α1 and α2 receptors) |
| Mechanism of Action | Blocks α1 receptors, leading to vasodilation and decreased blood pressure | Irreversibly blocks α1 and α2 receptors, leading to prolonged vasodilation and decreased blood pressure |
| Duration of Action | Intermediate (12–24 hours) | Long-lasting (24–48 hours or more due to irreversible binding) |
| Half-Life | ~22 hours | 24 hours, but effects can last longer due to irreversible binding |
| Onset of Action | 1–2 hours | Slower onset, hours to days |
| Clinical Effects | Decreases blood pressure via vasodilation, less reflex tachycardia | Prolonged and sustained blood pressure control, higher reflex tachycardia due to α2 blockade |
| Side Effects | Dizziness, hypotension, mild reflex tachycardia | Orthostatic hypotension, tachycardia, nasal congestion, fatigue |