ISSN 1662-4009 (online)

ESPE Yearbook of Paediatric Endocrinology (2020) 17 3.14 | DOI: 10.1530/ey.17.3.14

ESPEYB17 3. Thyroid Thyroid cancer (1 abstracts)

3.14. Preoperative metabolic classification of thyroid nodules using mass spectrometry imaging of fine-needle aspiration biopsies

DeHoog RJ , Zhang J , Alore E , Lin JQ , Yu W , Woody S , Almendariz C , Lin M , Engelsman AF , Sidhu SB , Tibshirani R , Suliburk J & Eberlin LS



To read the full abstract: Proc Natl Acad Sci U S A. 2019;116:21401–21408.

This prospective diagnostic study used desorption electrospray ionization mass spectrometry (DESI-MS) to classify thyroid nodules by their metabolic signature, and more precisely their lipid profile. DESI-MS is a technique using charged aerosols of microdroplets which are sprayed onto a surface (e.g. tissue) to desorb and ionize molecules which are then analyzed by MS [1]. Statistical classifiers to discriminate normal vs. papillary thyroid carcinoma (PTC) and normal vs. follicular thyroid carcinoma (FTC) were developed on a large training set of 178 validated tissue samples. Benign, PTC and FTC could be discriminated mainly based on their lipid profiles (e.g. phosphoinositol species). The two classifier models to detect benign vs. malignant tissues showed high sensitivity and specificity in 69 prospectively analyzed clinical samples. Further, in the subgroup of undetermined cytology on fine-needle aspiration (FNA), preoperative DESI-MS-predicted classification (benign or malignant) was confirmed by postoperative histology of surgical samples in 20 of 24 cases.

This fascinating feasibility study provides a first convincing data on a new innovative technique possibly improving preoperative diagnostic accuracy of standard FNA cytology for thyroid nodules. However, due to small sample size, these promising results need to be confirmed in larger series and need also to be tested against diagnostic tools based on gene expression analysis of FNA smears, which are now established in clinical use. Although providing fascinating insights into tumor biology, an important drawback of DESI-MS is its complex and expensive technology, which might prevent routine clinical use outside large expert centers. Finally, whether pediatric PTC and FTC show the same metabolic profile as adult carcinomas and can be detected with the same degree of accuracy needs to be tested in future.

Reference:

1. Recent advances of ambient mass spectrometry imaging for biological tissues: A review. Xiao Y, Deng J, Yao Y, Fang L, Yang Y, Luan T. Anal Chim Acta. 2020:22;1117:74–88.

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