The following is a summary of “Clinical Use of Raman Spectroscopy Improves Diagnostic Accuracy for Indeterminate Thyroid Nodules,” published in the December 2022 issue of Endocrinology & Metabolism by Palermo, et al.

It was thought that doing a molecular study on thyroid fine-needle aspiration (FNA) specimens could help treat ambiguous nodules better. In surgically excised tissues, Raman spectroscopy (RS) may distinguish between benign and malignant thyroid tumors by creating differential structural patterns. For a study, researchers used thyroid gland FNA samples to assess the diagnostic performance of RS.

It was a prospective, single-center, blinded research. With uncertain or more alarming cytologic findings, they included 123 individuals (TIR3A-low-risk indeterminate lesion, TIR3B-high-risk indeterminate lesion, TIR4-suspicious of malignancy, TIR5-malignant). All participants had FNA procedures for RS analysis and were all surgical candidates as determined by international criteria. Using various statistical methods, they compared RS data, cytologic results, and final histologic evaluations (as the gold standard).

The research population was divided into the following groups: TIR3A:37, TIR3B:32, TIR4:16, and TIR5:38. Histologic findings in 30.9% of individuals were benign. The overall specificity of RS was 86.8% for diagnosing thyroid cancer in FNA samples, with 86.5% specificity in ambiguous cytologic categories. The specificity of RS rose to 87.5% for TIR3A in patients with high-risk ultrasonography categories and to 100% for TIR3B. 72.9% of patients identified as TIR3A and 31.3% of patients classified as TIR3B had benign histologic diagnoses. Based on RS testing that was positive, the total rate of needless surgery was lowered to 7.4% (TIR3A-33.3%, TIR3B-6.7%).

The groundbreaking use of RS for thyroid cytology demonstrated its value as a diagnostic tool and a reliable substitute for molecular research, enhancing the treatment of indeterminate nodules and minimizing needless surgery.