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. 2018 Oct;62(5):501-505.
doi: 10.20945/2359-3997000000069.

3T magnetic resonance spectroscopy as a powerful diagnostic modality for assessment of thyroid nodules

Leila Aghaghazvini  1 , Pirouz Pirouzi  2 , Hashem Sharifian  3 , Nasrin Yazdani  4 , Soheil Kooraki  2 , Afsoon Ghadiri  2 , Majid Assadi  5
Affiliations

3T magnetic resonance spectroscopy as a powerful diagnostic modality for assessment of thyroid nodules

Leila Aghaghazvini et al. Arch Endocrinol Metab. 2018 Oct.

Abstract

Objective: Magnetic resonance spectroscopy (MRS) is a powerful tool for structural studies of chemical compounds and biomolecules and also documented promising findings as a potential imaging technology in thyroid oncology. This prospective study was to ascertain the clinical significance of 3 Tesla MRS in the evaluation of patients with thyroid nodules (TNs) as an ancillary diagnostic technique for thyroid carcinoma.

Materials and methods: Magnetic resonance spectroscopy at 3T at echo- times (TEs) 136 and 270 ms was carried out on 15 patients with total number of 32 TNs larger than 1 cm3, which all were surgically resected. Choline (Chol) to creatine (Cr) ratio was assessed at 136 and 270 TEs on each nodule and a receiver operating characteristic (ROC) curve was used to determine optimal cut-off point. The findings were compared with histopathology of thyroid specimens.

Results: There were 23 benign and 9 malignant lesions (7 papillary and 2 follicular thyroid carcinomas). The mean values of Chol/Cr at 136 and 270 TEs was 2.28 ± 3.65 and 1.52 ± 1.67 respectively and the difference between benign and malignant nodules was only significant at 136 TEs. The study revealed that Chol/ Cr ratio cut-off point of 2.5 best correlates with histopathology results (sensitivity = 75%; specificity = 100%; PPV = 100%; NPV= 92%).

Conclusion: This preliminary study showed that 3T magnetic resonance spectroscopy might be a specific modality for the evaluation of thyroid nodules in differentiation of benign from malignant thyroid tissue. However, a larger series would give much greater confidence that this state-of-the-art technology will worth pursuing in clinical practice.

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Figures

Figure 1
Figure 1. Graph of a malignant thyroid nodule with a very high choline (Chol) to creatine (Cr) ratio on MRS.
Figure 2
Figure 2. Receiver operating characteristic curve analysis for the prediction of malignant thyroid nodules based on choline (Chol) to creatine (Cr) ratio at 136 TE.
See this image and copyright information in PMC

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