Since mutational analysis of single genes has not proven adequate in guiding management decisions in indeterminate or suspicious thyroid nodules, attention turned to using panels of molecular markers. Currently, the most common molecular tests in clinical use are Afirma® Gene Expression Classifier (GEC) and Thyroseq® V2 (28). Introduced in 2011 by Veracyte, the Afirma® GEC has been considered a “rule-out” malignancy test. It includes a 142-gene expression molecular assay and uses microarray technology to measure the mRNA expression profiles to determine whether a thyroid nodule is “suspicious” or “benign.” The test’s primary aim is to spare patients with cytologically indeterminate FNA samples unnecessary diagnostic surgery (29). Among indeterminate/suspicious nodules (Bethesda Type III–V), the test has both a high Se (92%) and high NPV (93%) (30) (Table 2). In contrast, it has a low Sp (52%) and PPV (47%), and cannot accurately identify malignant lesions alone.