Role of Magnetic Resonance Spectroscopy in Differentiating Benign From Malignant Thyroid Nodules, Taking Tissue Diagnosis as Gold Standard

Background: Magnetic Resonance Spectroscopy (MRS) is used to find out the molecular composition of components and to identify the compound presence. MRS can differentiate malignant lesions from benign lesions. Aim: To determine the diagnostic accuracy role of Magnetic Resonance Spectroscopy in differentiating benign from malignant thyroid nodules by taking tissue diagnosis as a gold standard. Methods: Almost70 patients with malignant thyroid nodule on clinical examination of age 30 - 70 of either gender were included. Patients with previous thyroid surgery and already biopsy proven malignant thyroid and contraindication to MRS were not included in this study. Magnetic Resonance Spectroscopy was done for choline peak and choline / creatine (Cho /Cr) ratio. The results then compared with tissue diagnosis. Results: Among MR-Spectroscopy positive patients, we found 46 patients to be true positive while 03 were false positive. Among 24 MR-Spectroscopy negative patients, 16 were true negative while 05 were false negative patients (p = 0.0001). Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of Magnetic Resonance Spectroscopy in diagnosing malignant thyroid nodule taking tissue diagnosis as gold standard was 93.51%, 84.35%, 95.24%, 79.51% 91.40% respectively. Conclusion: After conducting the study, we concluded that MRS is the non-invasive imaging of choice with high diagnostic accuracy in analyzing malignant thyroid nodules.