Departments of Electrical Engineering, Convergence IT Engineering, Mechanical Engineering, Graduate School of Artificial Intelligence, and Medical Device Innovation Center, Pohang University of Science and Technology (POSTECH), Pohang, Gyeongbuk, Republic of Korea.
Bio-X Program, Molecular Imaging Program at Stanford (MIPS), Department of Radiology, School of Medicine, Stanford University, Stanford, California.
Cancer Res. 2021 Sep 15;81(18):4849-4860. doi: 10.1158/0008-5472.CAN-20-3334. Epub 2021 Jun 21.
Thyroid cancer is one of the most common cancers, with a global increase in incidence rate for both genders. Ultrasound-guided fine-needle aspiration is the current gold standard to diagnose thyroid cancers, but the results are inaccurate, leading to repeated biopsies and unnecessary surgeries. To reduce the number of unnecessary biopsies, we explored the use of multiparametric photoacoustic (PA) analysis in combination with the American Thyroid Association (ATA) Guideline (ATAP). In this study, we performed multispectral PA imaging on thyroid nodules from 52 patients, comprising 23 papillary thyroid cancer (PTC) and 29 benign cases. From the multispectral PA data, we calculated hemoglobin oxygen saturation level in the nodule area, then classified the PTC and benign nodules with multiparametric analysis. Statistical analyses showed that this multiparametric analysis of multispectral PA responses could classify PTC nodules. Combining the photoacoustically indicated probability of PTC and the ATAP led to a new scoring method that achieved a sensitivity of 83% and a specificity of 93%. This study is the first multiparametric analysis of multispectral PA data of thyroid nodules with statistical significance. As a proof of concept, the results show that the proposed new ATAP scoring can help physicians examine thyroid nodules for fine-needle aspiration biopsy, thus reducing unnecessary biopsies. SIGNIFICANCE: This report highlights a novel photoacoustic scoring method for risk stratification of thyroid nodules, where malignancy of the nodules can be diagnosed with 83% sensitivity and 93% specificity.
甲状腺癌是最常见的癌症之一,无论男女,全球发病率都呈上升趋势。超声引导下细针抽吸术是目前诊断甲状腺癌的金标准,但结果并不准确,导致重复活检和不必要的手术。为了减少不必要的活检次数,我们探索了多参数光声(PA)分析结合美国甲状腺协会(ATA)指南(ATAP)的应用。在这项研究中,我们对 52 名患者的甲状腺结节进行了多光谱 PA 成像,其中包括 23 例甲状腺乳头状癌(PTC)和 29 例良性病例。从多光谱 PA 数据中,我们计算了结节区域的血红蛋白氧饱和度水平,然后使用多参数分析对 PTC 和良性结节进行分类。统计分析表明,这种多参数分析多光谱 PA 响应可以对 PTC 结节进行分类。将光声指示的 PTC 概率与 ATAP 相结合,形成了一种新的评分方法,其灵敏度为 83%,特异性为 93%。这是第一项具有统计学意义的甲状腺结节多光谱 PA 数据的多参数分析研究。作为概念验证,结果表明,所提出的新 ATAP 评分可以帮助医生检查甲状腺结节进行细针抽吸活检,从而减少不必要的活检。意义:本报告强调了一种新的光声评分方法,用于甲状腺结节的风险分层,该方法可以以 83%的灵敏度和 93%的特异性诊断结节的恶性程度。