Medical Radiology and Radiation Safety. 2017. Vol. 62. No. 6. P. 39-45

DIAGNOSTIC RADIOLOGY

DOI: 10.12737/article_5a2536051fdc29.99266085

X-Ray Fluorescence Analysis in the Diagnosis of Thyroid Cancer

V.E. Zaichik, G.A. Davydov

A.F. Tsyb Medical Radiological Research Center, Obninsk, Russia, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. ; This email address is being protected from spambots. You need JavaScript enabled to view it.

V.E. Zaichick – Leading Researcher, Prof., Dr. Sc. Biol., PhD Tech., Fellow of the Royal Society of Chemistry;

G.A. Davydov – Head of the Nuclear Medicine Department, PhD Med.

Abstract

Purpose: Wide distribution of thyroid nodules and high risk of their transformation into malignant tumours specify the urgency of the methods for differential diagnostics used to make true diagnoses in time and to determine the adequate volume of surgical intervention. The aim of the study was to investigate new possibilities of differential diagnosis of benign and malignant thyroid nodules using energy dispersive X-ray fluorescence analysis (EDXRF) of trace element contents in tissue of thyroid lesions.

Material and methods: In the samples of thyroid tissue taken from people with intact thyroid gland (mostly died from trauma, n = 92, mean of age 44 years), as well as in patients with nodular goiter (n = 79, mean of age 44 years) and thyroid cancer (n = 40, mean of age 46 years) the contents of bromine (Br), copper (Cu), iron (Fe), iodine (I), rubidium (Rb), strontium (Sr), and zinc (Zn) were measured. To determine these element contents, the methods of EDXRF was developed using encapsulated sources with ¹⁰⁹Cd and ²⁴¹Am radionuclides to excite the fluorescence in the samples of thyroid tissue.

Results: The accuracy of the developed methods and the reliability of the results obtained in the study were confirmed by the measurements of international certified reference material IAEA H-4 Animal Muscles and the good agreement with data of its certificate. It was found that the Br, Cu, I, Rb, Sr, and Zn contents in malignant and benign thyroid nodules differ from the normal level of these elements in thyroid tissue. The cancer tissue differs for considerably lower content of iodine in comparison with the normal thyroid (almost 23 times on an average) and with the benign thyroid nodules (20 times), and also somewhat lower content of zinc (25 %). At the same time the higher levels of Cu, Rb, and Sr are a more typical composition of thyroid cancer tissue. Finally, it was shown that the level of I content, the ratios I/Cu and I/Rb, as well as the multiplication of the ratios (I/Cu) (I/Rb) and (I/Br) (I/Cu) (I/Rb) are highly informative markers of thyroid cancer.

Conclusion: The method of EDXRF analysis allow to determine the Br, Cu, Fe, I, Rb, Sr, and Zn contents in the tissue specimen, obtained by the large-needle biopsy of thyroid nodes, for a few minutes. It provides in vitro estimation of these element contents in the biopsy specimens prior to histologic study. The use of the proposed markers such as the level of I content, the ratios I/Cu and I/Rb, as well as the multiplication of the ratios (I/Cu) (I/Rb) and (I/Br) (I/Cu) (I/Rb) allow the differentiation of thyroid cancer from benign nodules and normal tissue with sensitivity in the range of 86–100 %, specificity of 89–99 %, and accuracy within 90–99 %.

Key words: thyroid goiter, thyroid cancer, chemical elements of thyroid tissue, X-ray fluorescence analysis

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For citation: Zaichik VE, Davydov GA. X-Ray Fluorescence Analysis in the Diagnosis of Thyroid Cancer. Medical Radiology and Radiation Safety. 2017;62(6):39-45. Russian. DOI: 10.12737/article_5a2536051fdc29.99266085

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