Effectiveness of Diffusion-weighted Magnetic Resonance Imaging (DW-MRI) in the Differentiation of Thyroid Nodules

Overview

Journal Thyroid Res

Specialty Endocrinology

Date 2024 Nov 17

PMID 39551736

Authors

Bilgen Mehpare Ozer

Yuksel Pabuscu

Serdar Tarhan

Gulgun Yilmaz Ovali

Hasan Aydede

Peyker Demireli

Tugba Karadeniz

Affiliations

Soon will be listed here.

Abstract

Background: The aim was to investigate which of two different b values (b 500 s/mm² and b 800 s/mm²) are more effective in the differentiation of benign-malignant nodules using Diffusion-Weighted Magnetic Resonance Imaging (DW-MRI).

Materials And Methods: Patients presenting with a preoperative diagnosis of nodular goiter or multinodular goiter were included in this study. These patients underwent neck MRI examinations, and their cases were analyzed retrospectively. A total of 26 patients were included in the study. A total of 46 nodules meeting the study criteria were examined. Measurements were performed on Apparent Diffusion Coefficient (ADC) maps of patients at two different b values (b 500 s/mm² and b 800 s/mm²), and the results were compared with histopathological findings.

Results: Out of a total of 46 nodules, 37 were identified as benign, and 9 as malignant based on histopathological analysis. The mean ADC value at b 500 was lower in malignant nodules (1259.65 ± 328.13) compared to benign nodules (19037.48 ± 472.74). Similarly, the mean ADC value at b 800 was lower in malignant nodules (1081.72 ± 200.23) compared to benign nodules (1610.44 ± 418.06). When a cut-off value of 1.1 × 10 was accepted for the differentiation of pathology, the sensitivity for distinguishing pathology with ADC values at b 500 was 83.3%, with a specificity of 90.0%, and for ADC values at b 800, the sensitivity was 71.4%, with a specificity of 89.7%.

Conclusion: DW-MRI without the need for contrast agent administration is a useful method in the differentiation of benign-malignant thyroid nodules.

References

Schueller-Weidekamm C, Kaserer K, Schueller G, Scheuba C, Ringl H, Weber M . Can quantitative diffusion-weighted MR imaging differentiate benign and malignant cold thyroid nodules? Initial results in 25 patients. AJNR Am J Neuroradiol. 2008; 30(2):417-22. PMC: 7051398. DOI: 10.3174/ajnr.A1338. View

Chen L, Xu J, Bao J, Huang X, Hu X, Xia Y . Diffusion-weighted MRI in differentiating malignant from benign thyroid nodules: a meta-analysis. BMJ Open. 2016; 6(1):e008413. PMC: 4716219. DOI: 10.1136/bmjopen-2015-008413. View

Tezuka M, Murata Y, Ishida R, Ohashi I, Hirata Y, Shibuya H . MR imaging of the thyroid: correlation between apparent diffusion coefficient and thyroid gland scintigraphy. J Magn Reson Imaging. 2003; 17(2):163-9. DOI: 10.1002/jmri.10247. View

Alvarado-Santiago M, Alvarez-Valentin D, Ruiz-Bermudez O, Gonzalez-Sepulveda L, Allende-Vigo M, Santiago-Rodriguez E . Fine-Needle Thyroid Aspiration Biopsy: Clinical Experience at the Endocrinology Clinics of the University Hospital of Puerto Rico. P R Health Sci J. 2017; 36(1):5-10. PMC: 5624044. View

Erdem G, Erdem T, Muammer H, Mutlu D, Firat A, Sahin I . Diffusion-weighted images differentiate benign from malignant thyroid nodules. J Magn Reson Imaging. 2009; 31(1):94-100. DOI: 10.1002/jmri.22000. View

Frates M, Benson C, Charboneau J, Cibas E, Clark O, Coleman B . Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement. Radiology. 2005; 237(3):794-800. DOI: 10.1148/radiol.2373050220. View

Gharib H, Papini E, Garber J, Duick D, Harrell R, Hegedus L . AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS, AMERICAN COLLEGE OF ENDOCRINOLOGY, AND ASSOCIAZIONE MEDICI ENDOCRINOLOGI MEDICAL GUIDELINES FOR CLINICAL PRACTICE FOR THE DIAGNOSIS AND MANAGEMENT OF THYROID NODULES--2016 UPDATE. Endocr Pract. 2016; 22(5):622-39. DOI: 10.4158/EP161208.GL. View

Eghtedari M, Ma J, Fox P, Guvenc I, Yang W, Dogan B . Effects of magnetic field strength and b value on the sensitivity and specificity of quantitative breast diffusion-weighted MRI. Quant Imaging Med Surg. 2016; 6(4):374-380. PMC: 5009097. DOI: 10.21037/qims.2016.07.06. View

Aghaghazvini L, Sharifian H, Yazdani N, Hosseiny M, Kooraki S, Pirouzi P . Differentiation between benign and malignant thyroid nodules using diffusion-weighted imaging, a 3-T MRI study. Indian J Radiol Imaging. 2019; 28(4):460-464. PMC: 6319093. DOI: 10.4103/ijri.IJRI_488_17. View

10.

Wang J, Takashima S, Takayama F, Kawakami S, Saito A, Matsushita T . Head and neck lesions: characterization with diffusion-weighted echo-planar MR imaging. Radiology. 2001; 220(3):621-30. DOI: 10.1148/radiol.2202010063. View

11.

Grussendorf M, Ruschenburg I, Brabant G . Malignancy rates in thyroid nodules: a long-term cohort study of 17,592 patients. Eur Thyroid J. 2022; 11(4). PMC: 9254276. DOI: 10.1530/ETJ-22-0027. View

12.

Abdel Razek A, Sadek A, Kombar O, Elmahdy T, Nada N . Role of apparent diffusion coefficient values in differentiation between malignant and benign solitary thyroid nodules. AJNR Am J Neuroradiol. 2007; 29(3):563-8. PMC: 8118879. DOI: 10.3174/ajnr.A0849. View

13.

Bozgeyik Z, Coskun S, Dagli A, Ozkan Y, Sahpaz F, Ogur E . Diffusion-weighted MR imaging of thyroid nodules. Neuroradiology. 2009; 51(3):193-8. DOI: 10.1007/s00234-008-0494-3. View

14.

Zhu X, Wang J, Wang Y, Zhu Z, Tang J, Wen X . Quantitative differentiation of malignant and benign thyroid nodules with multi-parameter diffusion-weighted imaging. World J Clin Cases. 2022; 10(24):8587-8598. PMC: 9453341. DOI: 10.12998/wjcc.v10.i24.8587. View

15.

Kizilkaya M, Erozgen F, Akinci M, Kaplan R, Tuzun S, Citlak G . The predictive value of elastography in thyroid nodules and its comparison with fine-needle aspiration biopsy results. Ulus Cerrahi Derg. 2015; 30(3):147-52. PMC: 4379851. DOI: 10.5152/UCD.2014.2519. View

16.

Meyer H, Wienke A, Surov A . Discrimination between malignant and benign thyroid tumors by diffusion-weighted imaging - A systematic review and meta analysis. Magn Reson Imaging. 2021; 84:41-57. DOI: 10.1016/j.mri.2021.09.006. View

17.

Razek A, Soliman N, Elkhamary S, Alsharaway M, Tawfik A . Role of diffusion-weighted MR imaging in cervical lymphadenopathy. Eur Radiol. 2006; 16(7):1468-77. DOI: 10.1007/s00330-005-0133-x. View