Hui Tan1, Jun Chen2, Yi Ling Zhao3, Jin Huan Liu3, Liang Zhang3, Chang Sheng Liu3, Dongjie Huang3. 1. Department of Radiology, Renmin Hospital of Wuhan University, No. 99, Zhang Zhidong Road, Wuhan 430060, Hubei, China. Electronic address: tanyath@163.com. 2. Department of Radiology, Renmin Hospital of Wuhan University, No. 99, Zhang Zhidong Road, Wuhan 430060, Hubei, China. Electronic address: whuchenjun@163.com. 3. Department of Radiology, Renmin Hospital of Wuhan University, No. 99, Zhang Zhidong Road, Wuhan 430060, Hubei, China.
Abstract
RATIONALE AND OBJECTIVES: This study aimed to preliminarily investigate the feasibility of intravoxel incoherent motion (IVIM) theory in the differential diagnosis of benign and malignant thyroid nodules. MATERIALS AND METHODS: Forty-five patients with 56 confirmed thyroid nodules underwent preoperative routine magnetic resonance imaging and IVIM diffusion-weighted imaging. The histopathologic diagnosis was confirmed by surgery. Apparent diffusion coefficient (ADC), perfusion fraction f, diffusivity D, and pseudo-diffusivity D* were quantified. Independent samples t test of IVIM-derived metrics were conducted between benign and malignant nodules. Receiver-operating characteristic analyses were performed to determine the optimal thresholds as well as the sensitivity and specificity for differentiating. RESULTS: Significant intergroup difference was observed in ADC, D, D*, and f (p < 0.001). Malignant tumors featured significantly lower ADC, D and D* values and a higher f value than that of benign nodules. The ADC, D, and D* could distinguish the benign from malignant thyroid nodules, and parameter f differentiate the malignant tumors from benign nodules. The values of the area under the curve for parameter ADC, D, and D* were 0.784 (p = 0.001), 0.795 (p = 0.001), and 0.850 (p < 0.001), separately, of which the area under the curve of f value was the maximum for identifying the malignant from benign nodules, which was 0.841 (p < 0.001). CONCLUSION: This study suggested that ADC and IVIM-derived metrics, including D, D*, and f, could potentially serve as noninvasive predictors for the preoperative differentiating of thyroid nodules, and f value performed best in identifying the malignant from benign nodules among these parameters.
RATIONALE AND OBJECTIVES: This study aimed to preliminarily investigate the feasibility of intravoxel incoherent motion (IVIM) theory in the differential diagnosis of benign and malignant thyroid nodules. MATERIALS AND METHODS: Forty-five patients with 56 confirmed thyroid nodules underwent preoperative routine magnetic resonance imaging and IVIM diffusion-weighted imaging. The histopathologic diagnosis was confirmed by surgery. Apparent diffusion coefficient (ADC), perfusion fraction f, diffusivity D, and pseudo-diffusivity D* were quantified. Independent samples t test of IVIM-derived metrics were conducted between benign and malignant nodules. Receiver-operating characteristic analyses were performed to determine the optimal thresholds as well as the sensitivity and specificity for differentiating. RESULTS: Significant intergroup difference was observed in ADC, D, D*, and f (p < 0.001). Malignant tumors featured significantly lower ADC, D and D* values and a higher f value than that of benign nodules. The ADC, D, and D* could distinguish the benign from malignant thyroid nodules, and parameter f differentiate the malignant tumors from benign nodules. The values of the area under the curve for parameter ADC, D, and D* were 0.784 (p = 0.001), 0.795 (p = 0.001), and 0.850 (p < 0.001), separately, of which the area under the curve of f value was the maximum for identifying the malignant from benign nodules, which was 0.841 (p < 0.001). CONCLUSION: This study suggested that ADC and IVIM-derived metrics, including D, D*, and f, could potentially serve as noninvasive predictors for the preoperative differentiating of thyroid nodules, and f value performed best in identifying the malignant from benign nodules among these parameters.
Authors: Qi-Yong Ai; Ann D King; Janet S M Chan; Weitian Chen; K C Allen Chan; John K S Woo; Benny C Y Zee; Anthony T C Chan; Darren M C Poon; Brigette B Y Ma; Edwin P Hui; Anil T Ahuja; Alexander C Vlantis; Jing Yuan Journal: Eur Radiol Date: 2019-03-22 Impact factor: 5.315