Objective: This study explores the potential use of high-resolution magic angle spinning proton magnetic resonance spectroscopy as an ancillary diagnostic technique for papillary thyroid carcinoma in thyroid fine-needle aspiration biopsies. The method has already been shown to be effective in the classification of various other nonthyroid cancers. Study Design: Twenty-six samples (13 paired cytologic and histologic samples) from patients being evaluated for thyroid abnormalities at the Massachusetts General Hospital were spectroscopically analyzed, and included: papillary thyroid carcinomas (n = 4), follicular adenomas (n = 4), and normal thyroid samples (n = 5). Metabolic profiles were statistically generated based on the spectroscopy results, which were then correlated with the final cytologic and histologic diagnoses from the same samples to determine the diagnostic capacity of the profiles. Results: Principal component analysis of the tissue samples revealed statistically significant correlations among principal components and various cytologic and histologic features. Canonical score 1, calculated with principal components in correlation with analyzed pathologies, revealed the ability of the metabolic profile to differentiate all three examined histologic tissue groups (ANOVA, p < 0.0001). Applying coefficients of principal components and canonical scores obtained with tissue samples directly onto spectral results of cytology samples, the calculated canonical score 1 also revealed similar trends among the three fine-needle aspiration biopsy groups. In particular, the papillary thyroid carcinoma group exhibited significant differences from both the adenomatous and normal cytology groups (p < 0.0170). Conclusions: The results indicate the potential of high-resolution magic angle spinning proton magnetic resonance spectroscopy as an ancillary marker for papillary thyroid carcinoma in fine-needle aspiration biopsy specimens.

1.
Hamberger B, Gharib H, Melton LJ 3rd, Goellner JR, Zinsmeister AR: Fine-needle aspiration biopsy of thyroid nodules: impact on thyroid practice and cost of care. Am J Med 1982;73:381–384.
2.
Ravetto C, Colombo L, Dottorini ME: Usefulness of fine-needle aspiration in the diagnosis of thyroid carcinoma: a retrospective study in 37,895 patients. Cancer 2000;90:357–363.
3.
Faquin WC: The thyroid gland: recurring problems in histologic and cytologic evaluation. Arch Pathol Lab Med 2008;132:622–632.
4.
Renshaw AA: Accuracy of thyroid fine-needle aspiration using receiver operator characteristic curves. Am J Clin Pathol 2001;116:477–482.
5.
Lewis CM, Chang KP, Pitman M, Faquin WC, Randolph GW: Thyroid fine-needle aspiration biopsy: variability in reporting. Thyroid 2009;19:717–723.
6.
DeLellis R, Lloyd R, Heitz P, Eng C: World Health Organization Classification of Tumors: Tumours of Endocrine Organs. Lyon, IARC Press, 2004.
7.
Stewart B, Kleihues P: World Cancer Report. Lyon, IARC Press, 2003.
8.
Rosai J, Carcangiu M, DeLellis R: Atlas of Tumor Pathology: Tumors of the Thyroid Gland. Washington, Armed Forces Institute of Pathology, 1992.
9.
Ali S, Cibas E: The Bethesda System for Reporting Thyroid Cytopathology. New York, Springer, 2010.
10.
Ohori NP, Nikiforova MN, Schoedel KE, et al: Contribution of molecular testing to thyroid fine-needle aspiration cytology of ‘follicular lesion of undetermined significance/atypia of undetermined significance’. Cancer Cytopathol 2010;118:17–23.
11.
Nikiforova MN, Nikiforov YE: Molecular diagnostics and predictors in thyroid cancer. Thyroid 2009;19:1351–1361.
12.
Cheng LL, Ma MJ, Becerra L, et al: Quantitative neuropathology by high resolution magic angle spinning proton magnetic resonance spectroscopy. Proc Natl Acad Sci USA 1997;94:6408–6413.
13.
Cheng LL, Burns MA, Taylor JL, et al: Metabolic characterization of human prostate cancer with tissue magnetic resonance spectroscopy. Cancer Res 2005;65:3030–3034.
14.
Cheng LL, Pohl U: The role of NMR-based metabolomics in cancer; in Lindon JC, Nicholls JK, Holmes E (eds): The Handbook of Metabonomics and Metabolomics. Amsterdam, Elsevier, 2007, pp 345–374.
15.
King AD, Yeung DK, Ahuja AT, et al: In vivo 1H MR spectroscopy of thyroid carcinoma. Eur J Radiol 2005;54:112–117.
16.
Gupta N, Kakar AK, Chowdhury V, Gulati P, Shankar LR, Vindal A: Magnetic resonance spectroscopy as a diagnostic modality for carcinoma thyroid. Eur J Radiol 2007;64:414–418.
17.
Delbridge L, Lean C, Russell P, et al: Proton magnetic resonance and human thyroid neoplasia II: potential avoidance of surgery for benign follicular neoplasms. World J Surg 1994;18:512–517.
18.
Lean C, Delbridge L, Russell P, et al: Diagnosis of follicular thyroid lesions by proton magnetic resonance on fine needle biopsy. J Clin Endocrinol Metab 1995;80:1306–1311.
19.
Mackinnon WB, Delbridge L, Russell P, et al: Two-dimensional proton magnetic resonance spectroscopy for tissue characterization of thyroid neoplasms. World J Surg 1996;20:841–847.
20.
Russell P, Lean C, Delbridge L, May G, Dowd S, Mountford CE: Proton magnetic resonance and human thyroid neoplasia. 1. Discrimination between benign and malignant follicular thyroid neoplasmas by magnetic resonance spectroscopy. Am J Med 1994;96:383–388.
21.
Rutter A, Kunnecke B, Dowd S, Russell P, Delbridge L, Mountford CE: Proton magnetic resonance and human thyroid neoplasia. 3. Ex vivo chemical-shift microimaging. J Magn Reson B 1996;110:240–248.
22.
Cheng LL, Lean CL, Bogdanova A, et al: Enhanced resolution of proton NMR spectra of malignant lymph nodes using magic-angle spinning. Magn Reson Med 1996;36:653–658.
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