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Diagnostic value of diffusion-weighted MR imaging in thyroid disease: application in differentiating benign from malignant disease.

Wu Y, Yue X, Shen W, Du Y, Yuan Y, Tao X, Tang CY - BMC Med Imaging (2013)

Bottom Line: Based on the histology results there were 28 benign and 14 malignant cases.The ADC values were significantly higher in benign lesions (benign ADC: 2.37 ± 0.47 × 10-3 mm(2)/s vs. malignant: 1.49 ± 0.60 × 10-3 mm(2)/s).Using the pathology results as a standard reference, area under ROC curve was found to be 0.876 for an ADC cutoff value of 2.17 × 10-3 mm(2)/s that corresponded to an acquisition with b-values of 0 and 300 mm(2)/s.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Background: Fine needle aspiration biopsy is usually performed to evaluate thyroid lesions. The purpose of this study was to evaluate the usefulness of diffusion weighted imaging to differentiate malignancy of thyroid lesions.

Methods: The study was approved by ethics committee of Shanghai Changzheng Hospital.Forty-two patients, 10 men and 32 women (range: 20-72 years, mean age 42.4 years) with thyroid lesions were included in the study. Routine neck MR and diffusion-weighted MR imaging was performed using multiple b-values. ADC values were computed for the different b-values. Histological results of the thyroidectomy samples were obtained for all the patients. ADC values of benign and malignant thyroid lesions were compared with the pathology results. Logistic regression analysis was used to detect independent parameters for differentiating benign and malignancy of lesions.

Result: Based on the histology results there were 28 benign and 14 malignant cases. The difference of ADC value between benign and malignant thyroid lesions was significant for ADC values obtained using b-values of 0 and 300 s/mm(2) (p < 0.001). The ADC values were significantly higher in benign lesions (benign ADC: 2.37 ± 0.47 × 10-3 mm(2)/s vs. malignant: 1.49 ± 0.60 × 10-3 mm(2)/s). ADC values obtained with b-values of 0 and 300 mm(2)/s and max nodular diameter was regarded as the two most discriminative parameters for differentiating malignancy. Using the pathology results as a standard reference, area under ROC curve was found to be 0.876 for an ADC cutoff value of 2.17 × 10-3 mm(2)/s that corresponded to an acquisition with b-values of 0 and 300 mm(2)/s.

Conclusion: Diffusion-weighted MR imaging is a promising non-invasive method to differentiate malignancy in thyroid lesions.

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A-36-year-female patient with thyroid papillary carcinoma at left lobe and isthmuses is shown. (A-B) Non-contrast and contrast transversal images showed abnormal signal at left lobe and isthmus with multiple cysts (long arrows). (C-E) showed ADC value measured from ADC map with b factors of 300, 500 and 800 s/mm2, respectively. (F) ADC map generated at b-factor of 300 s/mm2.
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Figure 2: A-36-year-female patient with thyroid papillary carcinoma at left lobe and isthmuses is shown. (A-B) Non-contrast and contrast transversal images showed abnormal signal at left lobe and isthmus with multiple cysts (long arrows). (C-E) showed ADC value measured from ADC map with b factors of 300, 500 and 800 s/mm2, respectively. (F) ADC map generated at b-factor of 300 s/mm2.

Mentions: Using histology results to group the ADC values we found that the ADC values were significantly different (p < 0.001) between benign and malignant lesions for the ADC values computed for b = 300 s/mm2. Mean ADC value for benign group (Figure 1) is much higher than that for malignant group (Figure 2), with the values of 2.37 ± 0.47 × 10-3 mm2/s and 1.49 ± 0.60 × 10-3 mm2/s respectively. However, no significant difference was observed between the two groups for the ADC values obtained using b = 500 s/mm2 or 800 s/mm2 (Table 2). Sensitivity, specificity and AUC were also compared among three different b-factors. Highest sensitivity and AUC was observed at b-factor of 300 s/mm2 (Table 3).We also selected four variables (age, sex, ADC value, max nodular diameter) as independent variables to perform logistic regression analysis. Odds ratios (and 95% CIs) based on the logistic regression model were also calculated. The results obtained from the logistic regression model showed that ADC values obtained with a b factor of 300 s/mm2 (OR = 4.76, p <0.001) and max nodular diameter (OR = 3.22, p = 0.034) were the two most discriminative independent variables for differentiating between benign and malignant lesions (Table 2).


Diagnostic value of diffusion-weighted MR imaging in thyroid disease: application in differentiating benign from malignant disease.

Wu Y, Yue X, Shen W, Du Y, Yuan Y, Tao X, Tang CY - BMC Med Imaging (2013)

A-36-year-female patient with thyroid papillary carcinoma at left lobe and isthmuses is shown. (A-B) Non-contrast and contrast transversal images showed abnormal signal at left lobe and isthmus with multiple cysts (long arrows). (C-E) showed ADC value measured from ADC map with b factors of 300, 500 and 800 s/mm2, respectively. (F) ADC map generated at b-factor of 300 s/mm2.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750353&req=5

Figure 2: A-36-year-female patient with thyroid papillary carcinoma at left lobe and isthmuses is shown. (A-B) Non-contrast and contrast transversal images showed abnormal signal at left lobe and isthmus with multiple cysts (long arrows). (C-E) showed ADC value measured from ADC map with b factors of 300, 500 and 800 s/mm2, respectively. (F) ADC map generated at b-factor of 300 s/mm2.
Mentions: Using histology results to group the ADC values we found that the ADC values were significantly different (p < 0.001) between benign and malignant lesions for the ADC values computed for b = 300 s/mm2. Mean ADC value for benign group (Figure 1) is much higher than that for malignant group (Figure 2), with the values of 2.37 ± 0.47 × 10-3 mm2/s and 1.49 ± 0.60 × 10-3 mm2/s respectively. However, no significant difference was observed between the two groups for the ADC values obtained using b = 500 s/mm2 or 800 s/mm2 (Table 2). Sensitivity, specificity and AUC were also compared among three different b-factors. Highest sensitivity and AUC was observed at b-factor of 300 s/mm2 (Table 3).We also selected four variables (age, sex, ADC value, max nodular diameter) as independent variables to perform logistic regression analysis. Odds ratios (and 95% CIs) based on the logistic regression model were also calculated. The results obtained from the logistic regression model showed that ADC values obtained with a b factor of 300 s/mm2 (OR = 4.76, p <0.001) and max nodular diameter (OR = 3.22, p = 0.034) were the two most discriminative independent variables for differentiating between benign and malignant lesions (Table 2).

Bottom Line: Based on the histology results there were 28 benign and 14 malignant cases.The ADC values were significantly higher in benign lesions (benign ADC: 2.37 ± 0.47 × 10-3 mm(2)/s vs. malignant: 1.49 ± 0.60 × 10-3 mm(2)/s).Using the pathology results as a standard reference, area under ROC curve was found to be 0.876 for an ADC cutoff value of 2.17 × 10-3 mm(2)/s that corresponded to an acquisition with b-values of 0 and 300 mm(2)/s.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Background: Fine needle aspiration biopsy is usually performed to evaluate thyroid lesions. The purpose of this study was to evaluate the usefulness of diffusion weighted imaging to differentiate malignancy of thyroid lesions.

Methods: The study was approved by ethics committee of Shanghai Changzheng Hospital.Forty-two patients, 10 men and 32 women (range: 20-72 years, mean age 42.4 years) with thyroid lesions were included in the study. Routine neck MR and diffusion-weighted MR imaging was performed using multiple b-values. ADC values were computed for the different b-values. Histological results of the thyroidectomy samples were obtained for all the patients. ADC values of benign and malignant thyroid lesions were compared with the pathology results. Logistic regression analysis was used to detect independent parameters for differentiating benign and malignancy of lesions.

Result: Based on the histology results there were 28 benign and 14 malignant cases. The difference of ADC value between benign and malignant thyroid lesions was significant for ADC values obtained using b-values of 0 and 300 s/mm(2) (p < 0.001). The ADC values were significantly higher in benign lesions (benign ADC: 2.37 ± 0.47 × 10-3 mm(2)/s vs. malignant: 1.49 ± 0.60 × 10-3 mm(2)/s). ADC values obtained with b-values of 0 and 300 mm(2)/s and max nodular diameter was regarded as the two most discriminative parameters for differentiating malignancy. Using the pathology results as a standard reference, area under ROC curve was found to be 0.876 for an ADC cutoff value of 2.17 × 10-3 mm(2)/s that corresponded to an acquisition with b-values of 0 and 300 mm(2)/s.

Conclusion: Diffusion-weighted MR imaging is a promising non-invasive method to differentiate malignancy in thyroid lesions.

Show MeSH
Related in: MedlinePlus