BTF Research Award winner 2025

We asked Dr Mabrouk Ahmed more about her research project:

What is the name of your study?

 ‘Circulating Extracellular Vesicles as Diagnostic Biomarkers of Indeterminate Thyroid Nodules.’

What is the background to your study?

Thyroid nodules, or lumps in the thyroid gland, are very common and often harmless. However, about 7–15% of them will be cancer. Doctors usually perform an ultrasound scan to check them. They may also use a test called fine-needle aspiration (FNAC) to check suspicious nodules.

We can confirm whether the nodule is benign (not cancer) or a cancer in a large proportion of nodules. However, around 20–40% of these tests give unclear results. These are called ‘indeterminate’ lumps. This uncertainty often leads to surgery to remove part of the thyroid, just to get a clear diagnosis.

Fortunately, most of these cases turn out not to be cancer, but this means many people undergo unnecessary surgery. Surgery is associated with risks of complications, including the need for lifelong thyroid hormone supplementation in approximately a quarter of patients who have had half of their thyroid removed (hemithyroidectomy). Those patients whose nodules prove to be cancer following surgery, and after biopsy, will also sometimes need a second surgery to remove the cancer. This exposes patients to further risks of surgical complications.

A new technique called liquid biopsy offers a less invasive way to detect cancer. It looks for tiny particles released by tumours into the blood. One promising type of particle is Extracellular Vesicles (EVs). These are tiny bubbles shed by cells that carry important information like RNA, DNA and proteins. EVs are more stable and easier to detect than other blood-based markers. This makes them a powerful tool for identifying cancer without the need for surgery. This approach could help doctors make more accurate diagnoses and reduce unnecessary procedures. This would help improve patient care, health outcomes and save resources.

Why is the study needed?

Indeterminate thyroid nodules present a challenging situation for both patients and surgeons. Due to the significant health and financial implications for patients, there is an urgent need to search for diagnostic markers to differentiate patients who have cancer from those with benign lumps.

There are currently some tests available that use the FNAC material to examine the lump’s molecular content and identify whether it is a suspicious lump or not. This approach can be inferior to a blood test, as a small sample of cells from the lump only provides a limited sample that fails to reflect the holistic molecular profile of the lump.

Furthermore, these tests are very costly, and are currently only performed at a few specialised centres. Finally, these tests still have some limitations in their diagnostic accuracy.

What will your study do?

The study aims to build on pilot findings that have shown that the RNA and protein content of the EVs circulating in the bloodstream can be used as minimally invasive diagnostic markers for indeterminate thyroid lumps.

In this phase of this study, I will analyse EV samples from a larger cohort of patients to confirm findings and diagnostic accuracy. I will also explore other aspects of those EVs to investigate whether these can improve the ability to differentiate between cancer and benign indeterminate lumps.

How will you conduct the study?

I will first gain consent from patient volunteers with indeterminate thyroid lumps to draw blood samples. I will then isolate EVs from the blood and analyse the EV RNA and protein content to validate the findings of the pilot study.

“This award is indispensable to validate the findings of the pilot study and will pave the way for larger-scale multi-centre clinical trials and clinical application.”

What will the BTF Research Award fund?

The main bulk will be used to purchase kits and consumables to perform all the experiments. The award will also help fund patient and public involvement, and a small part of my salary so I can carry out the experiments.

How can patients get involved?

My main motivator during the pilot phase of the study came from talking to patients with indeterminate lumps. Hearing about the anxiety and stress of not knowing whether their lumps are cancer or not and the health and financial burdens they had to bear continues to drive my research.

I strongly welcome patients with indeterminate thyroid nodules to reach out to share their experiences with me at  [email protected] at any point in their medical journey. Patients will be involved in all stages of the research cycle. This will include helping shape and refine research questions, identifying research priorities, designing the study in the best possible way to suit patients’ needs, recruiting participants, and ensuring the language used in our information sheets, consent forms and research findings is accessible and easy to understand.

What potential does your study have for patients with thyroid nodules?

If we can differentiate patients with cancer from benign indeterminate thyroid nodules, this will mean patients with benign lumps can avoid surgery altogether and be managed more conservatively. This will also reduce stress for patients and reduce the burden on our overstretched NHS.

Making research happen

Thank you to everyone who donated to our Research Appeal. Your donations raised a phenomenal £15,000! These have helped us to fund this vital research – thank you!

We want to do more to advance understanding of thyroid disease and improve treatments. If you can, please donate to help us fund more important thyroid research studies. Thank you.