Diagnostic value of high b-value (2000 s/mm2) DWI for thyroid micronodules

Wang, Qingjun; Guo, Yong; Zhang, Jing; Ning, Hao-yong; Zhang, Xiliang; Lu, Yuanyuan; Shi, Qinglei

doi:10.1097/md.0000000000014298

Cited by 15 publications

(10 citation statements)

References 27 publications

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“…Leila et al reported that static MRI measurements like signal intensity and heterogeneity were not useful in distinguishing between benign and malignant lesions (31). However, Wang et al showed that DWI SIR was lower in benign nodules than in malignant ones (32), which corroborated with our ndings. In our study, we found that DWI SIR was another independent predictor of malignant nodules, with malignant nodules showing a higher DWI SIR .…”

Section: Comparison Of the Diagnostic Performance With Acr-tiradssupporting

confidence: 90%

Quantitative evaluation of diffusion-weighted MRI for differentiating benign and malignant thyroid nodules larger than 4 cm

Zheng

Xie

et al. 2023

Preprint

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Purpose We aimed to diagnose the benign or malignant of large thyroid nodules by quantitative analysis of diffusion-weighted imaging (DWI). Methods 82 thyroid nodules were investigated retrospectively and divided them into benign (n = 62) and malignant groups (n = 20). DWI data were acquired, and apparent diffusion coefficients (ADCs) were calculated. Univariate and multivariate logistic regression were conducted to identify independent predictors, and develop a prediction model. We performed receiver operating characteristic (ROC) analysis to determine the optimal threshold of risk factors, and constructed combined threshold models. Diagnostic performance metrics, including area under the ROC curve (AUC), accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the ratio of unnecessary fine-needle aspiration biopsy (UFNAB) of all models were calculated and compared with the American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) result. Results Two independent predictors of malignant nodules were identified by multivariate analysis: DWI signal intensity ratio (DWISIR, P = 0.007) and minimum ADC (ADCmin, P < 0.001). At a cutoff value of 0.198, the multivariate prediction model had an AUC of 0.946. The combined threshold model of DWISIR and ADCmin had the highest specificity up to 100% and the lowest UFNAB rate of 0%. Conclusion Quantitative DWI demonstrated favorable malignant thyroid nodule diagnostic efficacy. Combined thresholds of DWISIR and ADCmin greatly reduced the UFNAB.

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Section: Comparison Of the Diagnostic Performance With Acr-tiradssupporting

confidence: 90%

Quantitative evaluation of diffusion-weighted MRI for differentiating benign and malignant thyroid nodules larger than 4 cm

Zheng

Xie

et al. 2023

Preprint

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“…Quality of the machine could affect the result of examination [2,3]. In the recent literature, many authors have been deeply studying and analyzing the value of MRI in evaluating malignancy of thyroid [4][5][6]. With the advancement of high field magnetic resonance machines, especially the recent advanced pulse sequences, the oncology diagnosis of thyroid on MRI turns out to be a lot simpler.…”

Section: Introductionmentioning

confidence: 99%

Value of Diffusion Weighted MRI with Quantitative ADC Map in Diagnosis of Malignant Thyroid Disease

et al. 2019

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Thyroid nodule is a common disease in clinical practice. The diagnosis of malignant thyroid tumors determines the treatment strategy. Among a number of methods have claimed to help evaluating thyroid nodules, ultrasound is a usable one in spite of several disadvantages (dependent on the physician/technician, incomparable, etc.) and magnetic resonance imaging (MRI) accompanied by quantitative apparent diffusion coefficient (ADC) is a promising diagnostic tool. This study was designed to investigate the usefulness of ADC cut-off values and the protocol of thyroid MRI derived from quantitative diffusion weighted imaging (DWI) in differentiating benign and malignant thyroid nodules. The study was conducted on 93 patients with 128 thyroid nodules, diagnosed and underwent surgery at Hanoi Medical University Hospital. All the patients took thyroid MRI with different b levels (from 200 to 800). ADC value was calculated to each b level, and the statistical tests were conducted with the Statistical Package for Social Sciences (SPSS—Windows and Mac version 20) and STATA 12. The mean ADC with all the b ranging from 200 to 800 of malignant groups was significantly higher than the group of benign lesions (p from <0.001 to 0.01). We chose b = 500 as a standard b-value in the protocol of thyroid MRI. The ADC cut-off point for distinguishing malignant from benign thyroid lesions: 1.7 × 10−3 mm2/s with high accuracy (87.1%, 95% CI: 79.59–92.07%). The study revealed that quantitative diffusion weighted MRI with ADC measurement could potentially quantitatively differentiate between benign and malignant thyroid nodules.

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“…According to Abdel Razek et al [14], DWI combined with ADC maps can help identify metastatic non-necrotic lymph nodes and provide microscopic information about lymph node status. Recently, Wang et al [15] concluded that a high b value (2000 s/mm 2 ) has high accuracy for the differential diagnosis of benign and malignant thyroid micronodules.…”

Section: Discussionmentioning

confidence: 99%

A comparative analysis of diffusion-weighted imaging and ultrasound in thyroid nodules

et al. 2019

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BackgroundDiffusion-weighted imaging (DWI) and ultrasound are commonly used methods to examine thyroid nodules, but their comparative value is rarely studied. We evaluated the utility of DWI and ultrasound in differentiating benign and malignant thyroid nodules.MethodsA total of 100 patients with 137 nodules who underwent both DWI and ultrasound before operation were enrolled. The T1 and T2 signal intensity ratio (SIR) of each thyroid nodule was calculated by measuring the mean signal intensity divided by that of paraspinal muscle. The apparent diffusion coefficient (ADC) value and the SIR of benign and malignant thyroid nodules were analyzed by two-sample independent t tests. The sensitivity, specificity, and accuracy of DWI and ultrasound were compared with chi-square tests.ResultsThere was no significant difference in the SIR between benign and malignant thyroid nodules. The ADC value was significantly different. At the threshold value was 1.12 × 10− 3 mm2/s, the maximum area under the curve was 0.944. The sensitivity, specificity, and accuracy were 84.9, 92.2, and 87.6% respectively. The corresponding values of ultrasound diagnosis were 90.1, 80.4, and 86.9%.ConclusionsUltrasound has high sensitivity in differentiating benign and malignant thyroid nodules, and the ADC value has high specificity, but there is no statistical difference in sensitivity or specificity between the two modalities. DWI and ultrasound each have their own advantages in differentiating benign and malignant thyroid nodules.

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Diagnostic value of high b-value (2000 s/mm2) DWI for thyroid micronodules

Cited by 15 publications

References 27 publications

Quantitative evaluation of diffusion-weighted MRI for differentiating benign and malignant thyroid nodules larger than 4 cm

Quantitative evaluation of diffusion-weighted MRI for differentiating benign and malignant thyroid nodules larger than 4 cm

Value of Diffusion Weighted MRI with Quantitative ADC Map in Diagnosis of Malignant Thyroid Disease

A comparative analysis of diffusion-weighted imaging and ultrasound in thyroid nodules

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