Utility of Diffusion-Weighted Imaging in Differentiating Malignant From Benign Thyroid Nodules With Magnetic Resonance Imaging and Pathologic Correlation

Shi, Hai Feng; Feng, Qinglai; Qiang, Jin Wei; Li, Ruo Kun; Wang, Li; Yu, Jian

doi:10.1097/rct.0b013e31828d28f0

Cited by 30 publications

(28 citation statements)

References 17 publications

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“…One false negative case was detected in our study (Papillary carcinoma -ADC-1.87 x 10 -3 ) and on histopathology necrosis with haemorrhage was detected within the lesion. The results are in par with the meta-analysis done by Chen L. (18) The result is comparable with Shi HF et al (19) who did a comparative study of Utility of diffusion-weighted imaging in differentiating malignant from benign thyroid nodules with magnetic resonance imaging and pathologic correlation. The majority (65%) of malignant thyroid nodules showed slightly hyperintense, and the majority (69%) of benign nodules were hyperintense on DWI (P < 0.01).…”

Section: Discussionsupporting

confidence: 80%

Differentiation Between Benign and Malignant Thyroid Nodule With Diffusion Weighted Magnetic Resonance Imaging and Apparent Diffusion Coefficient Measurements and Its Histopathological Correlation

Noufal¹,

Ramakrishnan²,

Kurup³

et al. 2018

jemds

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BACKGROUNDThe aetiology of thyroid nodules is diverse. Benign causes include the colloid nodule and the classical multinodular goiter. Occasionally, Hashimoto's thyroiditis and Grave's disease may present with nodularity. Malignant causes include thyroid cancer, lymphoma as well as metastasis to the thyroid glands. The objectives of the study were to compare ADC value of indeterminate thyroid nodules (includes TIRADS 3, 4 & 5) with their histopathology and then evaluate its role in differentiating malignant from benign thyroid nodules. MATERIALS AND METHODSThe prospective study was conducted in Department of Radiology and Imaging Sciences, Malabar Institute of Medical Sciences Ltd, Calicut, Kerala between 1 st October 2015 to 30 th March 2017, for a period of 18 months. The study population for analysis is the patients undergoing ultrasound thyroid, detected to have TIRADS 3, 4 and 5 lesions. All patients presenting with indeterminate thyroid nodule on ultrasonography in our hospital are subjected to MRI DW sequences the ADC was calculated. RESULTSA total of 80 patients with USG diagnosis of indeterminate thyroid nodule (TIRADS 3, 4 & 5) that came to the department before undergoing surgery were included in the study. For all these patients, T2 weighted MRI, diffusion weighted imaging and ADC mapping was done. Histopathology findings of each patient is collected and correlated with MRI findings to finalize the diagnosis. The sensitivity and specificity for various ADC values were calculated from ROC curve and it was noted the best ADC value for differentiating benign from malignant thyroid nodules according to our study is 1.745 with the highest sensitivity and specificity to qualify it as a screening test. The positive predictive value and negative predictive value when taking 1.745 as cut off ADC are 89.5% & and 98.4% respectively. The mean ADC of the malignant thyroid nodules (1.52± 0.23 x 10 -3 mm 2 /s) was significantly lower than that of the mean ADC of the benign thyroid nodules (2.25± 0.41 x 10 -3 mm 2 /s). Range of mean ADC value for benign lesions was 1.56 -3.33 and for malignant lesions was 0.96 -1.87. The proportion of cases with malignancy increases with decreasing ADC value. 17 out of 18 malignant cases were having an ADC value of less than 1.745 (Sensitivity -94.4%). CONCLUSIONThe study showed MRI with diffusion weighted imaging and ADC mapping is a promising tool in the armamentarium for the differentiation of benign and malignant thyroid nodules.

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Section: Discussionsupporting

confidence: 80%

Differentiation Between Benign and Malignant Thyroid Nodule With Diffusion Weighted Magnetic Resonance Imaging and Apparent Diffusion Coefficient Measurements and Its Histopathological Correlation

Noufal¹,

Ramakrishnan²,

Kurup³

et al. 2018

jemds

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“…For children, core needle biopsy may be achieved without an increased complication risk, although the accuracy of diagnosing malignancy seems to be equivalent to FNA [21]. Although immunohistochemical panels, PET, MRI and US seem promising to predict malignancy in adult thyroid nodules, none of the methods have been trialed specifically in a pediatric population, probably because of the rareness of the disease [22][23][24][25][26][27]. Furthermore, neither of the modalities can exclude malignancy.…”

Section: Tablementioning

confidence: 92%

Risk of malignancy for each Bethesda class in pediatric thyroid nodules

Norlén

Charlton

Sarkis

et al. 2015

Journal of Pediatric Surgery

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“…Apparent diffusion coefficient (ADC) is a derived quantitative imaging metric from DWI and measures water molecular diffusivity 4 . Initial studies have shown ADC as a novel quantitative imaging biomarker (QIB) in clinical applications ranging from detection of tumor to differentiation between benign and malignant thyroid tissue in patients 5–11 . However, severe geometric distortion and ghosting artifacts which is usually suffered from the conventinal full field-of-view (fFOV) DWI images in the region of thyroid glands impact heavily on the performance of the fFOV DWI technique and influence significantly its applicability in quantitative investigation 8, 12–14 .…”

Section: Introductionmentioning

confidence: 99%

Repeatability Investigation of Reduced Field-of-View Diffusion-Weighted Magnetic Resonance Imaging on Thyroid Glands

Hatzoglou

Banerjee

et al. 2015

Journal of Computer Assisted Tomography

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Objective To investigate the repeatability of the quantitative magnetic resonance imaging (MRI) metric (apparent diffusion coefficient (ADC)) derived from reduced field-of-view diffusion-weighted (rFOV DWI) on thyroid glands in a clinical setting. Materials and Methods Ten healthy human volunteers were enrolled in MRI studies performed on a 3T MRI scanner. Each volunteer was designed to undergo 3 longitudinal exams (2 weeks apart) with 2 repetitive sessions within each exam, which included rFOV and conventional full field-of-view (fFOV) DWI scans. DWI images were assessed and scored based on image characteristics. ADC values of thyroid glands from all subjects were calculated based on regions of interest. Repeatability analysis was performed based on the framework proposed by the Quantitative Imaging Biomarker Alliance (QIBA), generating four repeatability metrics: within-subject variance (σw2), repeatability coefficients (RC), intraclass correlation coefficient (ICC) and within-subject coefficient of variation (wCV). Student t test was employed to compare the performance difference between rFOV and fFOV DWI. Results The overall image quality from rFOV DWI was significantly higher than that from fFOV DWI (p=0.04). The ADC values calculated from rFOV DWI were significantly lower than corresponding values from fFOV DWI (p<0.001). There was no significant difference in ADC values across sessions and exams in either rFOV or fFOV DWI (p>0.05). rFOV DWI had lower values of σw2, RC, and wCV and a higher value of ICC compared to fFOV DWI either across sessions and exams. Conclusion This study demonstrated that rFOV DWI produced more superior quality DWI images and more repeatable ADC measurements compared to fFOV DWI, thus providing a feasible quantitative imaging tool for investigating thyroid glands in clinical settings.

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Utility of Diffusion-Weighted Imaging in Differentiating Malignant From Benign Thyroid Nodules With Magnetic Resonance Imaging and Pathologic Correlation

Abstract: Diffusion-weighted imaging can be a promising noninvasive imaging to discriminate malignant from benign nodules.

Cited by 30 publications

References 17 publications

Differentiation Between Benign and Malignant Thyroid Nodule With Diffusion Weighted Magnetic Resonance Imaging and Apparent Diffusion Coefficient Measurements and Its Histopathological Correlation

Differentiation Between Benign and Malignant Thyroid Nodule With Diffusion Weighted Magnetic Resonance Imaging and Apparent Diffusion Coefficient Measurements and Its Histopathological Correlation

Risk of malignancy for each Bethesda class in pediatric thyroid nodules

Repeatability Investigation of Reduced Field-of-View Diffusion-Weighted Magnetic Resonance Imaging on Thyroid Glands

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