Design, conduct and challenges of a clinical trial utilizing elastic light scattering spectroscopy in the thyroid
© Rosen et al; licensee BioMed Central Ltd. 2010
Published: 29 October 2010
Thyroid cancer is the most common endocrine malignancy. The standard of care in the management of a patient with a thyroid nodule is fine-needle aspiration biopsy (FNA) with cytological evaluation. While 5-10% of nodules are malignant, 10-25% of FNAs are indeterminate. Consequently, about twice as many patients undergo surgery for a suspicious lesion that turns out to be benign as undergo surgery for a known malignant lesion. A more accurate molecular and ultrastructural based algorithm would be useful to improve diagnostic accuracy. Noninvasive optical tissue diagnosis mediated by fiber-optic probes can be used to perform non-invasive, or minimally-invasive, real-time assessment of tissue pathology in-situ. Elastic light-scattering spectroscopy (ESS) is a point spectroscopic measurement technique, which is sensitive to cellular and subcellular morphological features. Normal and abnormal tissues can generate different spectral signatures as a result of changes in nuclear size, density, and other sub-cellular features, the optical-spectroscopy equivalent of histopathological readings. ESS is optimal for use in the small-volume area as found in thyroid FNA. An important advantage of ESS is that it provides an objective and quantitative assessment of tissue pathology that may not require on-site special expertise and subjective image interpretation as in conventional histopathology. Here we will describe our experience in the clinical application of elastic scattering spectroscopy in the thyroid.
This article is published under license to BioMed Central Ltd.