Ruo-Yang Shi1, Qiu-Ying Yao1, Qin-Yi Zhou2, Qing Lu1, Shi-Teng Suo1, Jun Chen2, Wen-Jie Zheng2, Yong-Ming Dai3, Lian-Ming Wu4, Jian-Rong Xu5. 1. Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160, Pujian Road, Shanghai, 200127, China. 2. Department of Head and Neck Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. 3. Magnetic Resonance Imaging Institute for Biomedical Research, Wayne State University, Detroit, MI, USA. 4. Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160, Pujian Road, Shanghai, 200127, China. wlmssmu@126.com. 5. Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160, Pujian Road, Shanghai, 200127, China. xujrrj@163.com.
Abstract
OBJECTIVES: To evaluate the utility of diffusion kurtosis imaging (DKI) of patients with thyroid nodules and to assess the probable correlation with histopathological factors. METHODS: The study included 58 consecutive patients with thyroid nodules who underwent magnetic resonance imaging (MRI) examination, including DKI and diffusion-weighted imaging (DWI). Histopathological analysis of paraffin sections included cell density and immunohistochemical analysis of Ki-67 and vascular endothelial growth factor (VEGF). Statistical analyses were performed using Student's t-test, receiver operating characteristic (ROC) curves and Spearman's correlation. RESULTS: The diffusion parameters, cell density and immunohistochemistry analysis between malignant and benign lesions showed significant differences. The largest area under the ROC curve was acquired for the D value (AUC = 0.797). The highest sensitivity was shown with the use of K (threshold = 0.832, sensitivity = 0.917). The Ki-67 expression generally stayed low. A moderate correlation was found between ADC, D and cell density (r = -0.536, P = 0.000; r = -0.570, P = 0.000) and ADC, D and VEGF expression (r = -0.451, P = 0.000; r = -0.522, P = 0.000). CONCLUSION: The DKI-derived parameters D and K demonstrated an advantage compared to conventional DWI for thyroid lesion diagnosis. While the histopathological study indicated that the D value correlated better with extracellular change than the ADC value, the K value probably changed relative to the intracellular structure. KEY POINTS: • DWI and DKI parameters can identify PTC from benign thyroid nodules. • Correlations were found between diffusion parameters and histopathological analysis. • DKI obtains better diagnostic accuracy than conventional DWI.
OBJECTIVES: To evaluate the utility of diffusion kurtosis imaging (DKI) of patients with thyroid nodules and to assess the probable correlation with histopathological factors. METHODS: The study included 58 consecutive patients with thyroid nodules who underwent magnetic resonance imaging (MRI) examination, including DKI and diffusion-weighted imaging (DWI). Histopathological analysis of paraffin sections included cell density and immunohistochemical analysis of Ki-67 and vascular endothelial growth factor (VEGF). Statistical analyses were performed using Student's t-test, receiver operating characteristic (ROC) curves and Spearman's correlation. RESULTS: The diffusion parameters, cell density and immunohistochemistry analysis between malignant and benign lesions showed significant differences. The largest area under the ROC curve was acquired for the D value (AUC = 0.797). The highest sensitivity was shown with the use of K (threshold = 0.832, sensitivity = 0.917). The Ki-67 expression generally stayed low. A moderate correlation was found between ADC, D and cell density (r = -0.536, P = 0.000; r = -0.570, P = 0.000) and ADC, D and VEGF expression (r = -0.451, P = 0.000; r = -0.522, P = 0.000). CONCLUSION: The DKI-derived parameters D and K demonstrated an advantage compared to conventional DWI for thyroid lesion diagnosis. While the histopathological study indicated that the D value correlated better with extracellular change than the ADC value, the K value probably changed relative to the intracellular structure. KEY POINTS: • DWI and DKI parameters can identify PTC from benign thyroid nodules. • Correlations were found between diffusion parameters and histopathological analysis. • DKI obtains better diagnostic accuracy than conventional DWI.
Authors: Harri Merisaari; Jussi Toivonen; Marko Pesola; Pekka Taimen; Peter J Boström; Tapio Pahikkala; Hannu J Aronen; Ivan Jambor Journal: Magn Reson Imaging Date: 2015-07-26 Impact factor: 2.546
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