By Diagnostics World News Staff
October 7, 2019 | Researchers at The University of Texas at Austin and Baylor College of Medicine have developed a new preoperative test for thyroid cancer that is faster and about two-thirds more accurate than the diagnostic tests doctors use today. Although more validation will be necessary before it can be used clinically, the new metabolic thyroid test shows promise for preventing thousands of unnecessary thyroid removals each year, such as the partial removal UT Austin grad student Amanda Helms had due to an inconclusive test.
The results appeared in the journal Proceedings of the National Academy of Sciences.
"If we could prevent people from having surgery they don't need and enable them to have a more precise diagnosis, we can improve treatment for patients and lower costs for the health care system," Livia S. Eberlin, assistant professor of chemistry and diagnostic medicine at The University of Texas at Austin and co-principal investigator, said in a press release.
Each year in the U.S., about 52,000 new cases of thyroid cancer are diagnosed. Unfortunately, the test used for diagnosis, called fine needle aspiration (FNA), is inconclusive about 1 out of every 5 times. When a pathologist is unable to confirm the presence of cancer, the patient may receive a follow-up genetic test that itself can produce false positive results.
Given the uncertainties, doctors often recommend removing part or all of the thyroid—the gland in the neck producing hormones that control the body's metabolic rate, as well as heart and digestive function, muscle control, brain development, mood and bone maintenance. Thousands of patients each year have the surgery only to later learn it was unnecessary.
Using a technology called mass spectrometry imaging, the new metabolic thyroid test identifies metabolites produced by cancerous cells that act as a kind of diagnostic fingerprint. The researchers worked on identifying these diagnostic metabolic fingerprints for over two years using 178 patient tissues before starting a pilot clinical study. During the clinical study, 68 new patients were tested, nearly a third of whom had received inconclusive FNA results. The new metabolic thyroid test returned a false positive only about 1 time in 10 and could have prevented 17 patients in the study from undergoing unnecessary surgeries.
The team is now preparing to start a two-year validation study on FNAs from about a thousand new patients collected in the U.S., Brazil, and Australia. If the results hold up, they hope the technology will be translated to the clinic as a routine diagnostic tool.