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2010 Annual Meeting Abstracts

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Elastic Scattering Spectroscopy (ESS) for Discrimination of Benign from Malignant Disease in Thyroid Nodules
Hyunsuk Suh, *Samuel Kim, *Susannah Orzell, *Ousama A'amar, *Eladio Rodriguez, *Stephanie Lee, *Irving Bigio, Jennifer E Rosen
Boston University, Boston, MA

• Elastic Scattering System (ESS) is an optical-biopsy technique mediated by fiber-optic probes and spectrometer that are sensitive to cellular and subcellular morphological features. We assessed the diagnostic potential of ESS to differentiate benign from malignant thyroid nodules.

• Conduct an IRB approved study of ESS data from thyroid nodules from patients undergoing thyroidectomy.
• Co-register the ESS reading sites with a blinded independent histopathology review.

• Study conducted at an academic institution.
• Patients undergoing total or near total thyroidectomy with thyroid nodules.
• None
Main Outcome Measures:
• 36 patients (21 benign, 15 malignant) or 900 spectra (500 benign, 400 malignant) were analyzed. Averaged Spectra data were analyzed using principal component analysis then linear discriminant analysis.
• Using the “Leave-one-out” method, sensitivity and specificity were obtained.
• Subclass analyses were performed on patients with an indeterminate FNA on cytology (N=17; 10 benign, 7 malignant).
• The sensitivity and the specificity of ESS were 75% and 95%, respectively. The positive predictive value (PPV) and negative predictive value (NPV) were 0.92 & 0.83.
• The indeterminate FNA subclass analysis revealed sensitivity and specificity of 0.86 & 1.00, while PPV and NPV were 1.00 and 0.91

• ESS can differentiate benign from malignant thyroid nodules with high PPV and NPV using ex vivo specimens.
• Compared to FNA, ESS has much higher PPV.
• In indeterminate FNA specimens, this high PPV could potentially prevent a significant number of unnecessary surgeries.
• ESS could potentially provide minimally invasive, operator-independent real time assessment of thyroid nodules.

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