Download PDF
CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2018; 28(04): 460-464
DOI: 10.4103/ijri.IJRI_488_17
Endocrine (Thyroid, Adrenal, Breast)

Differentiation between benign and malignant thyroid nodules using diffusion-weighted imaging, a 3-T MRI study

Leila Aghaghazvini
Department of Radiology, Shariati Hospital, Tehran, Iran
,
Hashem Sharifian
Department of Radiology, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
,
Nasrin Yazdani
Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
,
Melina Hosseiny
Department of Radiology, Shariati Hospital, Tehran, Iran
,
Saina Kooraki
Department of Radiology, Shariati Hospital, Tehran, Iran
,
Pirouz Pirouzi
Department of Radiology, Shariati Hospital, Tehran, Iran
,
Afsoon Ghadiri
Department of Radiology, Shariati Hospital, Tehran, Iran
,
Madjid Shakiba
Advanced Diagnostic and Interventional Radiologic Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
,
Soheil Kooraki
Department of Radiology, Shariati Hospital, Tehran, Iran
› Author Affiliations
Subject Editor: Financial support and sponsorship Nil.
› Further Information
   Permissions and Reprints

Abstract

Background: Preoperative differentiation of benign from malignant thyroid nodules remains a challenge. Aims: This study assessed the accuracy of diffusion-weighted imaging (DWI) for differentiation between benign and malignant thyroid nodules. Materials and Methods: Preoperative DWI was performed in patients with thyroid nodule by means of a 3-T scanner magnetic resonance imaging (MRI). Images were obtained at b value of 50, 500, and 1000 mm2/s to draw an ADC (apparent diffusion coefficient) map. Findings were compared with postoperative histopathologic results. Receiver operating characteristic curve was used to assess the accuracy of different cutoff points. Results: Forty-one thyroid nodules (26 benign and 15 malignant) were included in this study. None of static MRI parameters such as signal intensity, heterogeneity, and nodule border was useful to discriminate between benign and malignant lesions. Mean ADC value was (1.94 ± 0.54) × 10−3 mm2/s and (0.89 ± 0.29) × 10−3 mm2/s in benign and malignant nodules, respectively (P-value < 0.005). ADC value cutoff of 1 × 10−3 mm2/s yielded an accuracy, sensitivity, and specificity of 93%, 87%, and 96% to discriminate benign and malignant nodules. Conclusion: DWI is highly accurate for discrimination between benign and malignant thyroid nodules.

Keywords

Diffusion - nodule - thyroid


Publication History

Article published online:
26 July 2021

© 2018. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Gharib H, Papini E, Paschke R, Duick DS, Valcavi R, Hegedüs L. et al. American association of clinical endocrinologists, associazione medici endocrinologi, and European thyroid association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: Executive summary of recommendations. Endocr Pract 2010; 16: 468-75
    CrossrefPubMedGoogle Scholar
  • 2 Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE. et al. 2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid 2016; 26: 1-133
    CrossrefPubMedGoogle Scholar
  • 3 Dean DS, Gharib H. In: De Groot LJ, Chrousos G, Dungan K, Feingold KR, Grossman A, Hershman JM. editor Fine-Needle Aspiration Biopsy of the Thyroid Gland. South Dartmouth (MA): 2000
  • 4 Pinchot SN, Al-Wagih H, Schaefer S, Sippel R, Chen H. Accuracy of fine-needle aspiration biopsy for predicting neoplasm or carcinoma in thyroid nodules 4 cm or larger. Arch Surg 2009; 144: 649-55
    CrossrefPubMedGoogle Scholar
  • 5 Nachiappan AC, Metwalli ZA, Hailey BS, Patel RA, Ostrowski ML, Wynne DM. et al. The thyroid: Review of imaging features and biopsy techniques with radiologic-pathologic correlation. Radiographics 2014; 34: 276-93
    CrossrefPubMedGoogle Scholar
  • 6 Wu Y, Yue X, Shen W, Du Y, Yuan Y, Tao X, Tang CY. et al. Diagnostic value of diffusion-weighted MR imaging in thyroid disease: Application in differentiating benign from malignant disease. BMC Med Imaging 2013; 13: 23
    CrossrefPubMedGoogle Scholar
  • 7 Bozgeyik Z, Coskun S, Dagli AF, Ozkan Y, Sahpaz F, Ogur E. Diffusion-weighted MR imaging of thyroid nodules. Neuroradiology 2009; 51: 193-8
    CrossrefPubMedGoogle Scholar
  • 8 Erdem G, Erdem T, Muammer H, Mutlu DY, Firat AK. Diffusion-weighted images differentiate benign from malignant thyroid nodules. J Magn Reson Imaging 2010; 31: 94-100
    CrossrefPubMedGoogle Scholar
  • 9 Razek AA, Sadek AG, Kombar OR, Elmahdy TE, Nada N. Role of apparent diffusion coefficient values in differentiation between malignant and benign solitary thyroid nodules. AJNR Am J Neuroradiol 2008; 29: 563-8
    CrossrefPubMedGoogle Scholar
  • 10 Schueller-Weidekamm C, Kaserer K, Schueller G, Scheuba C, Ringl H, Weber M. et al. Can quantitative diffusion-weighted MR imaging differentiate benign and malignant cold thyroid nodules? Initial results in 25 patients. AJNR Am J Neuroradiol 2009; 30: 417-22
    CrossrefPubMedGoogle Scholar
  • 11 Mutlu H, Sivrioglu AK, Sonmez G, Velioglu M, Sildiroglu HO, Basekim CC. et al. Role of apparent diffusion coefficient values and diffusion-weighted magnetic resonance imaging in differentiation between benign and malignant thyroid nodules. Clin Imaging 2012; 36: 1-7
    CrossrefPubMedGoogle Scholar
  • 12 Malayeri AA, El Khouli RH, Zaheer A, Jacobs MA, Corona-Villalobos CP, Kamel IR. et al. Principles and applications of diffusion-weighted imaging in cancer detection, staging, and treatment follow-up. Radiographics 2011; 31: 1773-91
    CrossrefPubMedGoogle Scholar
  • 13 Baliyan V, Das CJ, Sharma R, Gupta AK. Diffusion weighted imaging: Technique and applications. World J Radiol 2016; 8: 785-98
    CrossrefPubMedGoogle Scholar
  • 14 Hagmann P, Jonasson L, Maeder P, Thiran JP, Wedeen VJ, Meuli R. Understanding diffusion MR imaging techniques: From scalar diffusion-weighted imaging to diffusion tensor imaging and beyond. Radiographics 2006; 26 Suppl (01) S205-23
    CrossrefPubMedGoogle Scholar
  • 15 Khizer AT, Raza S, Slehria AU. Diffusion-weighted MR imaging and ADC mapping in differentiating benign from malignant thyroid nodules. J Coll Physicians Surg Pak 2015; 25: 785-8
    PubMedGoogle Scholar
  • 16 Nakahira M, Saito N, Murata S, Sugasawa M, Shimamura Y, Morita K. et al. Quantitative diffusion-weighted magnetic resonance imaging as a powerful adjunct to fine needle aspiration cytology for assessment of thyroid nodules. Am J Otolaryngol 2012; 33: 408-16
    CrossrefPubMedGoogle Scholar
  • 17 Ilica AT, Artaş H, Ayan A, Günal A, Emer O, Kilbas Z. et al. Initial experience of 3 tesla apparent diffusion coefficient values in differentiating benign and malignant thyroid nodules. J Magn Reson Imaging 2013; 37: 1077-82
    CrossrefPubMedGoogle Scholar
  • 18 Chen L, Xu J, Bao J, Huang X, Hu X, Xia Y. et al. Diffusion-weighted MRI in differentiating malignant from benign thyroid nodules: A meta-analysis. BMJ Open 2016; 6: e008413
    CrossrefPubMedGoogle Scholar
  • 19 Anderson J. Tumors: General features, types and examples. In: Anderson JR. editor Muir’s Textbook of Pathology. London: Edward Arnold; 1992: 127-56
    Google Scholar