Towards a Raman-based diagnostic approach for characterizing cytologically indeterminate thyroid nodules

摘要

Thyroid nodules are very common, and their incidence increase with age. The majority of thyroid nodules are benign,but approximately 5-15% are thyroid cancer. The cornerstone to evaluation of most thyroid nodules is a neck ultrasoundfollowed by fine-needle aspiration (FNA) to evaluate for malignancy. Unfortunately, approximately 15-30% of FNAs areconsidered "indeterminate". In these cases, cytopathologist cannot determine if the thyroid nodule is benign or malignantbased on FNA alone. Although the majority of these "indeterminate" nodules are ultimately benign, majority of thesepatients require thyroidectomies to rule out cancer. This puts the patient at unnecessary risk of surgical complicationsand increases health care costs. A better method is needed to help physicians determine the risk of malignancy in patientswith indeterminate thyroid nodules. In recent years there has been much interest in the use of optical diagnostic in cancerdetection. Recent investigations potentially suggest that Raman spectroscopy (RS) can be used as a clinical tool thatcould confer great patient advantage with minimally invasive, non-destructive, rapid and accurate diagnosis. In thisstudy, we investigate the use of line-scan RS and imaging in combination with multivariate statistical analysis of thespectral data for objective identification and classification of single cells isolated from frozen samples of different typesof human thyroid nodules. Preliminary results indicate a high sensitivity and specificity for identifying different celltypes.