To Determine The Positive Predictive Value Of Magnetic Resonance Spectroscopy In Diagnosing Malignant Thyroid Nodules By Taking Histopathology As A Gold Standard
Keywords:
Magnetic resonance spectroscopy, Thyroid malignancy, Thyroid nodulesAbstract
Objective: To determine the positive predictive value of magnetic resonance spectroscopy in diagnosing malignant thyroid
nodules by taking histopathology as a gold standard.
Methodology: This descriptive cross-sectional study was undertaken at the department of Radiology, CMH Multan from October
2014 to March 2015. 77 patients with malignant thyroid nodules on ultrasonography between ages 30-70 years, of either gender
were included. Patients with previous thyroid surgery, already biopsy proven malignant thyroid nodules and, those having
contraindication to magnetic resonance spectroscopy (MRS) were excluded. All the patients then underwent MRS for choline
peak and choline /creatine (Cho/Cr) ratio. Findings were correlated with histopathology.
Results: Mean age of the patients was 46.53 ± 9.15 years. Out of these 77 patients, 62 (80.52%) were female and 15 (19.48%)
were males with female to male ratio of 4:1. MRS supported the diagnosis of malignant thyroid nodules in 60 patients.
Histopathology confirmed malignant thyroid nodules in 49 (true positive) cases where as 11 (False Positive) had no malignant
lesion on histopathology. Positive predictive value of magnetic resonance spectroscopy (MRS) in diagnosing malignant thyroid
nodules was 81.67%.
Conclusion: Magnetic resonance spectroscopy (MRS) is a non-invasive modality of choice with high positive predictive value
in diagnosing malignant thyroid nodules. It has not only dramatically improved our ability of diagnosing thyroid lesions pre-
operatively but also helps the surgeons for proper decision making.
References
Hegedus L. Clinical practice. The thyroid nodule. N Engl J Med. 2008;351(17):1764-71
Qureshi IA, Khabaz MN, Baig M, Begum B, Abdelrehaman AS, Hussain MB. Histopathological findings in goiter: A review of 624 thyroidectomies. Neuro Endocrinol Lett. 2015;36(1):48-52
Ma JJ, Ding H, Xu BH, Xu C, Song LJ, Huang BJ, et al. Diagnostic performances of various gray-scale, color Doppler, and contrast-enhanced ultrasonography findings in predicting malignant thyroid nodules. Thyroid. 2014; 24(2):355-63
Chen PY, Chiou SC, Yeh HY, Chen CP, Ho C, Lin JD, et al. Correlation of ultrasonography with fine needle aspiration cytology and final pathological diagnoses in patients with thyroid nodules. Chin J Radiol. 2010; 35: 1-7
Bennedbaek FN, Perrild H, Hegedüs L. Diagnosis and treatment of the solitary thyroid nodule. Results of a European survey. Clin Endocrinol (Oxf). 1999; 50(3): 357–63
Chaudhary V, Bano S. Imaging of the thyroid: Recent advances. Indian J Endo Metabol. 2012; 16(3): 371-6
Khalessi A, Phan-Thien KC. Imaging of the thyroid gland. N Z Med J. 2011;124(1342):82-8
Miyakoshi A, Dalley RW, Anzai Y. Magnetic resonance imaging of thyroid cancer. Top Magn Reson Imag. 2007; 18(4):293-302
Jordanb KW, Adkinsa CB, Chenga LL, Faquin WC. Application of magnetic-resonance-spectroscopy-based metabolomics to the fine-needle aspiration diagnosis of papillary thyroid carcinoma. Acta Cytologica. 2011;55 (6):584-9
Gupta N, Goswami B, Chowdhury V, Shankar LR, Kakar A. Evaluation of role of magnetic resonance spectroscopy in the diagnosis of follicular malignancies of thyroid. Arch Surg. 2011; 146(2):179-82
Yunus M, Ahmed Z. Significance of ultrasound features in predicting malignant solid thyroid nodules: need for fine needle aspiration. J Pak Med Assoc. 2010; 60(10): 848-53
Islam N. Thyroid carcinoma. J Pak Med Assoc. 2011; 61(10):949-50
Melak T, Mathewos B, Enawgaw B, Damtie D. Prevalence and types of thyroid malignancies among thyroid enlarged patients in Gondar, Northwest Ethiopia: a three years institution based retrospective study. BMC Cancer. 2014 Dec 2;14:899
Altekruse SF, Kosary CL, Krapcho M, NeymanN, Aminour R, et al. SEER Cancer Statistics Review, 1975- 2007. In: Bethesda MD, editor: National Cancer Institute, 2010
C tan R, Boil A, Borda A. Thyroid cancer profile in Mures County (Romania): a 20 years study. Rom J Mor- phol Embryol. 2012;53(4):1007-12
Shah SH, Muzaffar S, Soomro IN, Hasan SH. Morph- ological patterns and frequency of thyroid tumors. J Pak Med Assoc. 1999;49(6):131-3
Al-Salamah SM, Khalid K, Bismar HA. Incidence of differentiated cancer in nodular goiter. Saudi Med J 2002; 23:947-52
Mulaudi TV, Ramdial PK, Madiba TE, Challaghan RA. Thyroid carcinoma at King Edward VIII Hospital, Durban, South Africa. East Africa Med J 2001; 78: 252-5
Gharib H. Fine-needle aspiration biopsy of thyroid nodules: advantages, limitations, and effect. Mayo Clin Proc 1994;69(1):44-9
Frates MC, Benson CB, Charboneau JW, Cibas ES, Clark OH, Coleman BG. Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement. Radiology 2005; 237 (3):794-800
Hall TL, Layfield LJ, Philippe A, Rosenthal DL. Sources of diagnostic error in fine needle aspiration of the thyroid. Cancer 1989;63(4):718-25
King AD, Yeung DK, Ahuja AT. In vivo 1H MR spect- roscopy of thyroid carcinoma. Eur J Radiol. 2005;54(1): 112-7
Gupta N, Kakar AK, Chowdhury V. Magnetic resonance spectroscopy as a diagnostic modality for carcinoma thyroid. Eur J Radiol. 2007; 64(3):414-8
Gupta N, Goswami B, Chowdhury V, Shankar LR, Kakar A. Evaluation of role of magnetic resonance spectroscopy in the diagnosis of follicular malignancies of thyroid. Arch Surg. 2011;146(2):179-82
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Copyright (c) 2017 Zeeshan-ul-Hasnain Imdad, Mashkoor Ahmad, Faran Nasrullah
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