Role of magnetic resonance spectroscopy in differential diagnosis of solitary pulmonary lesions

PURPOSEThe aim of our study was to evaluate the availability of magnetic resonance spectroscopy (MRS) for the differentiation of benign or malignant pulmonary nodules and masses.METHODSA total of 59 patients (45 male, 14 female) with pulmonary nodules and masses were included in this prospective study. MRS was applied to the pulmonary lesions of the patients and choline levels were determined. Afterwards CT-guided percutaneous needle biopsy was performed. According to the biopsy results, pulmonary lesions were benign in 25 patients and malignant in 34 patients.RESULTSCholine levels were significantly higher in malignant lesions compared with benign lesions (p 1.65 µmol/g compared to those with choline levels ≤1.65 µmol/g (p < 0.001).CONCLUSIONMRS is a noninvasive method that can be used in the differential diagnosis of pulmonary nodules and masses

The Malignancy Risk Assessment Of Cytologically Indeterminate Thyroid Nodules Improves Markedly By Using A Predictive Model

Objectives: The majority of thyroid nodules are discovered incidentally, and the management may be a challenge if the fine needle aspiration specimen yields indeterminate findings. Our aim was to develop an individualized risk prediction model to provide an accurate estimate of cancer risk in patients with cytologically indeterminate thyroid nodules. Materials and Methods: Clinical records, ultrasound images, and cytopathology reports of patients who underwent thyroidectomy were retrospectively reviewed. Logistic regression analysis was used to identify the predictive ability of each variable for malignancy, and a nomogram was built by integrating patients' age, multiplicity of nodules, cytology results, and suspicious ultrasound features, such as microcalcifications and irregular margins. Results: For the 233 indeterminate nodules according to the Bethesda System for Reporting Thyroid Cytopathology, the malignancy rates of the subgroups “atypia of undetermined significance,” “suspicious follicular neoplasia,” and “suspicious for malignancy” were 44.3, 47.7, and 88.0%, respectively. It was found that the Bethesda category “suspicious for malignancy,” microcalcifications, and irregular margins were independent risk factors for malignancy. The area under the receiver operating characteristics curve was 0.784, which suggested that the presented nomogram had considerable discriminative performance. Conclusions: The nomogram developed in our study accurately predicts the malignancy risk of thyroid nodules with indeterminate cytology by using clinical, cytological, and ultrasonographic features. (C) 2018 European Thyroid Association Published by S. Karger AG, BaselWo