Role of apparent diffusion coefficient values and diffusion-weighted magnetic resonance imaging in differentiation between benign and malignant thyroid nodules

Mutlu, Hakan; Sivrioğlu, Ali Kemal; Sönmez, Güner; Velioglu, Murat; Sildiroglu, Huseyin Onur; Başekim, C. Çınar; Kızılkaya, Eşref

doi:10.1016/j.clinimag.2011.04.001

Cited by 39 publications

(32 citation statements)

References 14 publications

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“…Basharat et al (24) has compared thyroid scan with FNAB and suggests fine needle aspiration cytology is more specific than sensitive whereas thyroid scan is more sensitive than specific in detecting thyroid malignancy. In 2011, a study reported the highest values for sensitivity and specificity based on (nodule/ cord SI)/nodule apparent diffusion coefficient ratio using DW-MRI limited on 44 patients with nodules (25). Despite the high values for sensitivity and specificity, a missed malignancy would cause huge damage for the patient.…”

Section: Discussionmentioning

confidence: 99%

Multidetector computed tomography analysis of benign and malignant nodules in patients with chronic lymphocytic thyroiditis

et al. 2016

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Abstract. The aim of the present study was to compare the multidetector computed tomography (MDCT) features of benign and malignant nodules in patients with chronic lymphocytic thyroiditis (CLT). MDCT findings, including the size, solid percentage, calcification, margin, capsule, anteroposterior-transverse diameter ratio as well as the mode and the degree of enhancement of 137 thyroid nodules in 127 CLT cases were retrospectively analyzed. Furthermore, the correlation between MDCT findings and pathological results combined with the CT perfusion imaging was analyzed for the differences between benign and malignant nodules. A total of 77.5% (31/40) of malignant nodules were completely solid, and 33% (32/97) of benign nodules were predominantly cystic. Compared with the benign nodules, micro-calcification and internal calcification were more frequently observed in the malignant nodules (P<0.05). MDCT features such as ill-defined margin, absence of capsule or incomplete capsule or homogeneous enhancement were more likely to be present in the malignant nodules (P<0.05). Nevertheless, no significant difference was observed in the enhancement degree at arterial or venous phase between benign and malignant nodules (P>0.05). MDCT features are useful in differentiating the benign and malignant nodules in CLT patients, and it may be essential for a radiologist to review the MDCT characteristics of nodules in the clinical practice.

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Section: Discussionmentioning

confidence: 99%

Multidetector computed tomography analysis of benign and malignant nodules in patients with chronic lymphocytic thyroiditis

et al. 2016

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“…Recently, ADC value has shown potential as a surrogate imaging biomarker to assess tumor aggressiveness in breast (15), prostate (16)(17)(18), and rectal cancers (19). For thyroid cancers, DW-MRI has been applied in the assessment of thyroid nodules, especially for the differentiation of benign and malignant tumors (20)(21)(22)(23)(24)(25)(26)(27). The purpose of this study was to evaluate whether ADC calculated from DW-MRI data before surgery stratifies tumor aggressiveness as defined at surgical histopathology analysis in PTCs.…”

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confidence: 99%

Using Diffusion-Weighted MRI to Predict Aggressive Histological Features in Papillary Thyroid Carcinoma: A Novel Tool for Pre-Operative Risk Stratification in Thyroid Cancer

Moreira

Hatzoglou

et al. 2015

Thyroid

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Background: Initial management recommendations of papillary thyroid carcinoma (PTC) are very dependent on preoperative studies designed to evaluate the presence of PTC with aggressive features. The purpose of this study was to evaluate whether diffusion-weighted magnetic resonance imaging (DW-MRI) before surgery can be used as a tool to stratify tumor aggressiveness in patients with PTC. Methods: In this prospective study, 28 patients with PTC underwent DW-MRI studies on a three Tesla MR scanner prior to thyroidectomy. Due to image quality, 21 patients were finally suitable for further analysis. Apparent diffusion coefficients (ADCs) of normal thyroid tissues and PTCs for 21 patients were calculated. Tumor aggressiveness was defined by surgical histopathology. The Mann-Whitney U test was used to compare the difference in ADCs among groups of normal thyroid tissues and PTCs with and without features of tumor aggressiveness. Receiver operating characteristic (ROC) analysis was performed to assess the discriminative specificity, sensitivity, and accuracy of and determine the cutoff value for the ADC in stratifying PTCs with tumor aggressiveness. Results: There was no significant difference in ADC values between normal thyroid tissues and PTCs. However, ADC values of PTCs with extrathyroidal extension (ETE; 1.53 -0.25 · 10 -3 mm 2 /s) were significantly lower than corresponding values from PTCs without ETE (2.37 -0.67 · 10 -3 mm 2 /s; p < 0.005). ADC values identified 3 papillary carcinoma patients with extrathyroidal extension that would have otherwise been candidates for observation based on ultrasound evaluations. The cutoff value of ADC to discriminate PTCs with and without ETE was determined at 1.85 · 10 -3 mm 2 /s with a sensitivity of 85%, specificity of 85%, and ROC curve area of 0.85. Conclusion: ADC value derived from DW-MRI before surgery has the potential to stratify ETE in patients with PTCs.

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“…The reason why malignant tumours have lower ADC values are not well understood but is probably related to a combination of higher cellularity, tissue disorganization and increased extracellular space tortuosity, all contributing to reduced motion of water. 8 Although with different b-values and different optimal ADC thresholds, most previous studies inevitably proved the ability of DWI in differentiating malignant from benign head and neck tumours, [15][16][17][18][19][20][21][22][23][24] except that diagnostic dilemma exists in cholesteatoma, salivary gland tumours and lymph nodes. 8,25 However, the comparison of diagnostic ability between DWI and conventional MRI was less performed.…”

Section: Discussionmentioning

confidence: 99%

“…The conventional non-enhanced MRI protocol consisted of T 1 weighted (T1W) and T 2 weighted sequences (with fat suppression). DWI was performed using a single-shot spin-echo echoplanar imaging sequence with bvalues of 0 and 800 s mm 22 . Gradients were applied in three orthogonal directions.…”

Section: Mri Acquisitionmentioning

confidence: 99%

Palatal lesions: discriminative value of conventional MRI and diffusion weighted imaging

Yuan

Tang

Jiang

et al. 2016

BJR

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Objective: To evaluate and compare the ability of conventional MRI, diffusion-weighted imaging (DWI) and a combination of both MRI techniques to differentiate malignant and benign palatal lesions. Methods: A retrospective review of MRI findings was performed in patients with pathologically confirmed palatal lesions between January 2012 and December 2014. Each lesion was evaluated with conventional MRI characteristics, including enhancement, inner texture, margin, adjacent soft-tissue involvement and cervical lymph node, and/or apparent diffusion coefficient (ADC) value. Statistical analyses were performed to assess the differential performance of each parameter separately and together. Results: A total of 42 patients (24 males, 18 females; age: 54.9 6 16.4 years) were investigated. The optimal cut-off ADC value to distinguish malignant from benign lesions was 1.02 3 10 23 mm 2 s 21 , with a sensitivity of 87.5% and a specificity of 75.0%. Conventional MRI showed a sensitivity of 87.1% and a specificity of 63.6%. Combination of conventional MRI and ADC scores increased sensitivity to 100% and specificity to 75.0%. The AUCs did not differ significantly between conventional MRI alone, DWI alone and integration of both. Conclusion: Additional DWI does not substantially improve differential ability of conventional MRI. However, combining ADC values with conventional MRI improves both sensitivity and specificity, which is of worth to be further validated in prospective studies with larger sample sizes. Advances in knowledge: Combination of conventional MRI and ADC scores could increase the ability to differentiate malignant from benign palatal lesions, with a sensitivity of 100% and specificity of 75.0%, although without statistical significance. INTRODUCTIONThe palate separates the oral from the nasal cavity and is anatomically composed of soft and hard parts. The hard palate is composed of mucosal surface and minor salivary glands located between the mucosal surface and the underlying bone. The soft palate is formed by squamous mucosa and muscle fibers, and contains a smaller number of minor salivary glands compared with the hard part. Palatal lesions include a variety of pathological types, 1 and squamous cell carcinoma (SCC) is the most common malignancy. Tumours of the minor salivary glands are the most common type of submucosal masses, and malignant tumours account for approximately half of them.2 Various types of mesenchymal tumours, such as fibromas, lipomas, schwannomas, neurofibromas, haemangiomas and lymphangiomas, also involve the palate.

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Role of apparent diffusion coefficient values and diffusion-weighted magnetic resonance imaging in differentiation between benign and malignant thyroid nodules

Cited by 39 publications

References 14 publications

Multidetector computed tomography analysis of benign and malignant nodules in patients with chronic lymphocytic thyroiditis

Multidetector computed tomography analysis of benign and malignant nodules in patients with chronic lymphocytic thyroiditis

Using Diffusion-Weighted MRI to Predict Aggressive Histological Features in Papillary Thyroid Carcinoma: A Novel Tool for Pre-Operative Risk Stratification in Thyroid Cancer

Palatal lesions: discriminative value of conventional MRI and diffusion weighted imaging

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