This new test for thyroid cancer may prevent unnecessary surgery

In a new study, researchers have developed a new test for thyroid cancer that is faster and about two-thirds more accurate than the diagnostic tests doctors use today.

The new metabolic thyroid test shows promise for preventing thousands of unnecessary thyroid removals each year.

The research was conducted by a team at The University of Texas at Austin and Baylor College of Medicine.

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 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.

In the new study, the team used 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 improved accuracy would prevent unnecessary surgeries, many of which lead patients to need hormone replacement therapy for the rest of their lives or to have to cope with other consequences of having all or part of their thyroid removed.

The team says with this next-generation test, they can provide thyroid cancer diagnoses faster and with more precision than current techniques—this will be the new state-of-the-art.

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.

One author of the study is Livia S. Eberlin, assistant professor of chemistry and diagnostic medicine.

The study is published in the journal Proceedings of the National Academy of Sciences.

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