Introduction

“Indeterminate for malignancy” thyroid nodules (TIR3) are often surgically removed with heavy consequences for patients and for the national health system.

This patent use the MALDI-MS-Imaging proteomic technology to solve “indeterminate for malignancy” (TIR3) and “suspicious” (TIR4) cases providing a more correct diagnosis of thyroid lesione being able to discriminate malignat from beign lesions.

Technical features

A possible alternative is offered by a proteomic mass spectrometry imaging approach (MSI) able to identify the molecular signatures of specific proteins of different cells.

MSI is able to produce molecular images, for each type of analyte present in biopsy findings, complementary to those of microscopy or immunofluorescence, thus providing a molecular dimension to routine histopathology, but more informative as it highlights the alterations also in the single cell and therefore provides specific molecular signatures of normal or “altered” cells (see figure: functioning scheme). This peculiarity allows to identify the pathogenetic molecular “actors” to improve the understanding of the thyroid pathology and to translate them into clinical tools for patient care.

This approach based on the use of molecular signatures is now widely used for the detection and identification of microorganisms in various sectors (environmental, cosmetic, clinical, etc.).

Possible Applications

• Implementation of this diagnostic “tool” able to discriminate between benign and malignant thyroid lesion into anatomical-pathological units;
• The «tool» is extensible to other pathologies (eg nephropathies, pulmonary fibrosis, etc).

Advantages

• Reduce the number of unnecessary thyroidectomies;
• Improve the diagnosis of thyroid lesions;
• Reduce discomfort for patients due to unnecessary thyroid removal;
• Reduction of costs charged to the NHS both for surgical interventions and for the subsequent lifetime drug treatment.