title: Elastic light-scattering spectroscopy for discrimination of benign from malignant disease in thyroid nodules.
abstract: BACKGROUND
  Thyroid cancer is the most common endocrine malignancy. The current standard of diagnosis, fine-needle aspiration biopsy, yields approximately 10-25% of indeterminate results leading to twice as many thyroidectomies for further diagnosis. Elastic scattering spectroscopy (ESS) is a new, minimally invasive optical-biopsy technique mediated by fiber-optic probes that is sensitive to cellular and subcellular morphological features. We assessed the diagnostic potential of ESS in the thyroid to differentiate benign from malignant thyroid nodules as determined by histology.
  
  
  METHODS
  Under an IRB approved protocol, 36 surgical patients (n = 21 benign thyroid nodules, n = 15 malignant tumors) had collection of ESS data from their fresh ex vivo thyroidectomy specimens. Using surgical pathology as our gold standard, spectral analyses were performed using a training set; these data were used to assess the ESS diagnostic potential using the leave-one-out technique.
  
  
  RESULTS
  Our test set was 75% sensitive and 95% specific in differentiating benign from malignant thyroid lesions, with a positive predictive value (PPV) of 0.92 and a negative predictive value (NPV) of 0.83.
  
  
  CONCLUSIONS
  The ESS can accurately distinguish benign vs malignant thyroid lesions with high PPV and NPV. With further validation ESS could potentially be used as an in situ real-time diagnostic tool or as an adjunct to conventional cytology.
authors.affiliation: Department of Surgery, Boston University, Boston, MA, USA.
authors.forename: Hyunsuk
authors.initials: H
authors.lastname: Suh
authors.forename: Ousama
authors.initials: O
authors.lastname: A'amar
authors.forename: Eladio
authors.initials: E
authors.lastname: Rodriguez-Diaz
authors.forename: Stephanie
authors.initials: S
authors.lastname: Lee
authors.forename: Irving
authors.initials: I
authors.lastname: Bigio
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Rosen
mesh_terms: D018249:Adenoma, Oxyphilic / Q000175:diagnosis* / Q000601:surgery; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D025341:Principal Component Analysis; D012542:Scattering, Radiation; D012680:Sensitivity and Specificity; D013057:Spectrum Analysis; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000601:surgery; D016606:Thyroid Nodule / Q000175:diagnosis* / Q000601:surgery; D013965:Thyroidectomy