To Determine The Positive Predictive Value Of Magnetic Resonance Spectroscopy In Diagnosing Malignant Thyroid Nodules By Taking Histopathology As A Gold Standard

Abstract

Objective: To determine the positive predictive value of magnetic resonance spectroscopy in diagnosing malignant thyroid nodules by taking histopathology as a gold standard. Methodology: This descriptive cross-sectional study was undertaken at the department of Radiology, CMH Multan from October 2014 to March 2015. 77 patients with malignant thyroid nodules on ultrasonography between ages 30-70 years, of either gender were included. Patients with previous thyroid surgery, already biopsy proven malignant thyroid nodules and, those having contraindication to magnetic resonance spectroscopy (MRS) were excluded. All the patients then underwent MRS for choline peak and choline /creatine (Cho/Cr) ratio. Findings were correlated with histopathology. Results: Mean age of the patients was 46.53 ± 9.15 years. Out of these 77 patients, 62 (80.52%) were female and 15 (19.48%) were males with female to male ratio of 4:1. MRS supported the diagnosis of malignant thyroid nodules in 60 patients. Histopathology confirmed malignant thyroid nodules in 49 (true positive) cases where as 11 (False Positive) had no malignant lesion on histopathology. Positive predictive value of magnetic resonance spectroscopy (MRS) in diagnosing malignant thyroid nodules was 81.67%. Conclusion: Magnetic resonance spectroscopy (MRS) is a non-invasive modality of choice with high positive predictive value in diagnosing malignant thyroid nodules. It has not only dramatically improved our ability of diagnosing thyroid lesions pre- operatively but also helps the surgeons for proper decision making.