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Differentiation between malignant and benign thyroid nodules and stratification of papillary thyroid cancer with aggressive histological features: Whole‐lesion diffusion‐weighted imaging histogram analysis
Author(s) -
Hao Yonghong,
Pan Chu,
Chen WeiWei,
Li Tao,
Zhu WenZhen,
Qi JianPin
Publication year - 2016
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.25290
Subject(s) - thyroid nodules , medicine , papillary thyroid cancer , pathology , lesion , thyroid cancer , radiology , diffusion mri , thyroid , risk stratification , magnetic resonance imaging , malignancy
Purpose To explore the usefulness of whole‐lesion histogram analysis of apparent diffusion coefficient (ADC) derived from reduced field‐of‐view (r‐FOV) diffusion‐weighted imaging (DWI) in differentiating malignant and benign thyroid nodules and stratifying papillary thyroid cancer (PTC) with aggressive histological features. Materials and Methods This Institutional Review Board‐approved, retrospective study included 93 patients with 101 pathologically proven thyroid nodules. All patients underwent preoperative r‐FOV DWI at 3T. The whole‐lesion ADC assessments were performed for each patient. Histogram‐derived ADC parameters between different subgroups (pathologic type, extrathyroidal extension, lymph node metastasis) were compared. Receiver operating characteristic curve analysis was used to determine optimal histogram parameters in differentiating benign and malignant nodules and predicting aggressiveness of PTC. Results Mean ADC, median ADC, 5 th percentile ADC, 25 th percentile ADC, 75 th percentile ADC, 95 th percentile ADC (all P < 0.001), and kurtosis ( P = 0.001) were significantly lower in malignant thyroid nodules, and mean ADC achieved the highest AUC (0.919) with a cutoff value of 1842.78 × 10 ‐6 mm 2 /s in differentiating malignant and benign nodules. Compared to the PTCs without extrathyroidal extension, PTCs with extrathyroidal extension showed significantly lower median ADC, 5 th percentile ADC, and 25 th percentile ADC. The 5 th percentile ADC achieved the highest AUC (0.757) with cutoff value of 911.5 × 10 ‐6 mm 2 /s for differentiating between PTCs with and without extrathyroidal extension. Conclusion Whole‐lesion ADC histogram analysis might help to differentiate malignant nodules from benign ones and show the PTCs with extrathyroidal extension. J. Magn. Reson. Imaging 2016;44:1546–1555.