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Published in: Neuroradiology 3/2009

01-03-2009 | Head and Neck Radiology

Diffusion-weighted MR imaging of thyroid nodules

Authors: Zulkif Bozgeyik, Sonay Coskun, A. Ferda Dagli, Yusuf Ozkan, Fatih Sahpaz, Erkin Ogur

Published in: Neuroradiology | Issue 3/2009

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Abstract

Introduction

The purpose of our study was to determine the diagnostic role of diffusion-weighted imaging (DWI) in the differentiating of malignant and benign thyroid nodules by using fine needle aspiration biopsy cytology criteria as a reference standard. The apparent diffusion coefficient (ADC) values of the normal-looking thyroid parenchyma were also evaluated both in normal patients and in patients with nodules.

Methods

Between March 2007 and February 2008, 76 consecutive patients with ultrasound-diagnosed thyroid nodules and 20 healthy subjects underwent diffusion-weighted MR imaging by using single-shot spin echo, echo planar imaging. A total of 93 nodules were included in the study using the following b factors 100, 200, and 300 mm2/s. ADC values of thyroid nodules and normal area in all subjects were calculated and compared using suitable statistical analysis.

Results

Mean ADC values for malignant and benign nodules were \(0.96 \pm 0.65 \times 10^{ - 3} \) and \(3.06 \pm 0.71 \times 10^{ - 3} {{{\text{mm}}^2 } \mathord{\left/ {\vphantom {{{\text{mm}}^2 } {\text{s}}}} \right. \kern-\nulldelimiterspace} {\text{s}}}\) for b-100 factor, \(0.56 \pm 0.43 \times 10^{ - 3} \) and \(1.80 \pm 0.60 \times 10^{ - 3} {{{\text{mm}}^2 } \mathord{\left/ {\vphantom {{{\text{mm}}^2 } \operatorname{s} }} \right. \kern-\nulldelimiterspace} \operatorname{s} }\) for b-200, and \(0.30 \pm 0.20 \times 10^{ - 3} \) and \(1.15 \pm 0.43 \times 10^{ - 3} {{{\text{mm}}^2 } \mathord{\left/ {\vphantom {{{\text{mm}}^2 } \operatorname{s} }} \right. \kern-\nulldelimiterspace} \operatorname{s} }\), for b-300, respectively. Mean ADC values of malignant nodules were lower than benign nodules. There were significant differences in ADC values between benign and malignant nodules. ADC values among normal-appearing thyroid parenchyma of patients and normal-appearing thyroid parenchyma of healthy subjects were insignificant at all b factors.

Conclusion

Benign nodules have higher ADC values than malignant ones. DWI may be helpful in differentiating malign and benign thyroid nodules.
Literature
1.
go back to reference Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, Mazzaferri EL, McIver B, Sherman SI, Tuttle RM (2006) Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 16:109–142PubMedCrossRef Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, Mazzaferri EL, McIver B, Sherman SI, Tuttle RM (2006) Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 16:109–142PubMedCrossRef
3.
go back to reference Werk EE Jr, Vernon BM, Gonzalez JJ, Ungaro PC, McCoy RC (1984) Cancer in thyroid nodules. A community hospital survey. Arch Intern Med 144:474–476PubMedCrossRef Werk EE Jr, Vernon BM, Gonzalez JJ, Ungaro PC, McCoy RC (1984) Cancer in thyroid nodules. A community hospital survey. Arch Intern Med 144:474–476PubMedCrossRef
4.
go back to reference Maeda M, Kato H, Sakuma H, Maier SE, Takeda K (2005) Usefulness of the apparent diffusion coefficient in line scan diffusion-weighted imaging for distinguishing between squamous cell carcinomas and malignant lymphomas of the head and neck. AJNR Am J Neuroradiol 26:1186–1192PubMed Maeda M, Kato H, Sakuma H, Maier SE, Takeda K (2005) Usefulness of the apparent diffusion coefficient in line scan diffusion-weighted imaging for distinguishing between squamous cell carcinomas and malignant lymphomas of the head and neck. AJNR Am J Neuroradiol 26:1186–1192PubMed
5.
go back to reference Le Bihan D, Breton E, Lallemand D, Aubin ML, Vignaud J, Laval-Jeantet M (1988) Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging. Radiology 168:497–505PubMed Le Bihan D, Breton E, Lallemand D, Aubin ML, Vignaud J, Laval-Jeantet M (1988) Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging. Radiology 168:497–505PubMed
6.
go back to reference Warach S, Chien D, Li W, Ronthal M, Edelman RR (1992) Fast magnetic resonance diffusion-weighted imaging of acute human stroke. Neurology 42:1717–1723PubMed Warach S, Chien D, Li W, Ronthal M, Edelman RR (1992) Fast magnetic resonance diffusion-weighted imaging of acute human stroke. Neurology 42:1717–1723PubMed
8.
go back to reference Wang J, Takashima S, Takayama F, Kawakami S, Saito A, Matsushita T, Momose M, Ishiyama T (2001) Head and neck lesions: characterization with diffusion-weighted echo-planar MR imaging. Radiology 220:621–630PubMedCrossRef Wang J, Takashima S, Takayama F, Kawakami S, Saito A, Matsushita T, Momose M, Ishiyama T (2001) Head and neck lesions: characterization with diffusion-weighted echo-planar MR imaging. Radiology 220:621–630PubMedCrossRef
9.
go back to reference Eida S, Sumi M, Sakihama N, Takahashi H, Nakamura T (2007) Apparent diffusion coefficient mapping of salivary gland tumors: prediction of the benignancy and malignancy. AJNR Am J Neuroradiol 28:116–121PubMed Eida S, Sumi M, Sakihama N, Takahashi H, Nakamura T (2007) Apparent diffusion coefficient mapping of salivary gland tumors: prediction of the benignancy and malignancy. AJNR Am J Neuroradiol 28:116–121PubMed
10.
go back to reference King AD, Ahuja AT, Yeung DK, Fong DK, Lee YY, Lei KI, Tse GM (2007) Malignant cervical lymphadenopathy: diagnostic accuracy of diffusion-weighted MR imaging. Radiology 245:806–813PubMedCrossRef King AD, Ahuja AT, Yeung DK, Fong DK, Lee YY, Lei KI, Tse GM (2007) Malignant cervical lymphadenopathy: diagnostic accuracy of diffusion-weighted MR imaging. Radiology 245:806–813PubMedCrossRef
11.
go back to reference Razek AA, Sadek AG, Kombar OR, Elmahdy TE, Nada N (2008) Role of apparent diffusion coefficient values in differentiation between malignant and benign solitary thyroid nodules. AJNR Am J Neuroradiol 29:563PubMedCrossRef Razek AA, Sadek AG, Kombar OR, Elmahdy TE, Nada N (2008) Role of apparent diffusion coefficient values in differentiation between malignant and benign solitary thyroid nodules. AJNR Am J Neuroradiol 29:563PubMedCrossRef
12.
go back to reference Vander JB, Gaston EA, Dawber TR (1968) The significance of nontoxic thyroid nodules. Final report of a 15-year study of the incidence of thyroid malignancy. Ann Intern Med 69:537–540PubMed Vander JB, Gaston EA, Dawber TR (1968) The significance of nontoxic thyroid nodules. Final report of a 15-year study of the incidence of thyroid malignancy. Ann Intern Med 69:537–540PubMed
13.
14.
go back to reference Brander A, Viikinkoski P, Nickels J, Kivisaari L (1991) Thyroid gland: US screening in a random adult population. Radiology 181:683–687PubMed Brander A, Viikinkoski P, Nickels J, Kivisaari L (1991) Thyroid gland: US screening in a random adult population. Radiology 181:683–687PubMed
15.
go back to reference Mortensen JD, Woolner LB, Bennett WA (1955) Gross and microscopic findings in clinically normal thyroid glands. J Clin Endocrinol Metab 15:1270–1280PubMed Mortensen JD, Woolner LB, Bennett WA (1955) Gross and microscopic findings in clinically normal thyroid glands. J Clin Endocrinol Metab 15:1270–1280PubMed
16.
go back to reference Solbiati L, Osti V, Cova L, Tonolini M (2001) Ultrasound of thyroid, parathyroid glands and neck lymph nodes. Eur Radiol 11:2411–2424PubMedCrossRef Solbiati L, Osti V, Cova L, Tonolini M (2001) Ultrasound of thyroid, parathyroid glands and neck lymph nodes. Eur Radiol 11:2411–2424PubMedCrossRef
17.
go back to reference Tee YY, Lowe AJ, Brand CA, Judson RT (2007) Fine-needle aspiration may miss a third of all malignancy in palpable thyroid nodules: a comprehensive literature review. Ann Surg 246:714–720PubMed Tee YY, Lowe AJ, Brand CA, Judson RT (2007) Fine-needle aspiration may miss a third of all malignancy in palpable thyroid nodules: a comprehensive literature review. Ann Surg 246:714–720PubMed
18.
go back to reference Baur A, Huber A, Arbogast S, Dürr HR, Zysk S, Wendtner C, Deimling M, Reiser M (2001) Diffusion-weighted imaging of tumor recurrencies and posttherapeutical soft-tissue changes in humans. Eur Radiol 11:828–833PubMedCrossRef Baur A, Huber A, Arbogast S, Dürr HR, Zysk S, Wendtner C, Deimling M, Reiser M (2001) Diffusion-weighted imaging of tumor recurrencies and posttherapeutical soft-tissue changes in humans. Eur Radiol 11:828–833PubMedCrossRef
19.
go back to reference Ward R, Caruthers S, Yablon C, Blake M, DiMasi M, Eustace S (2000) Analysis of diffusion changes in posttraumatic bone marrow using navigator-corrected diffusion gradients. AJR Am J Roentgenol 174:731–734PubMed Ward R, Caruthers S, Yablon C, Blake M, DiMasi M, Eustace S (2000) Analysis of diffusion changes in posttraumatic bone marrow using navigator-corrected diffusion gradients. AJR Am J Roentgenol 174:731–734PubMed
20.
go back to reference Koh DM, Collins DJ (2007) Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol 188:1622–1635PubMedCrossRef Koh DM, Collins DJ (2007) Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol 188:1622–1635PubMedCrossRef
21.
go back to reference Abdel Razek AA, Soliman NY, Elkhamary S, Alsharaway MK, Tawfik A (2006) Role of diffusion-weighted MR imaging in cervical lymphadenopathy. Eur Radiol 16:1468–1477PubMedCrossRef Abdel Razek AA, Soliman NY, Elkhamary S, Alsharaway MK, Tawfik A (2006) Role of diffusion-weighted MR imaging in cervical lymphadenopathy. Eur Radiol 16:1468–1477PubMedCrossRef
22.
go back to reference King AD, Ahuja AT, Yeung DK, Fong DK, Lee YY, Lei KI, Tse GM (2007) Malignant cervical lymphadenopathy: diagnostic accuracy of diffusion-weighted MR imaging. Radiology 245:806–813PubMedCrossRef King AD, Ahuja AT, Yeung DK, Fong DK, Lee YY, Lei KI, Tse GM (2007) Malignant cervical lymphadenopathy: diagnostic accuracy of diffusion-weighted MR imaging. Radiology 245:806–813PubMedCrossRef
23.
go back to reference Tezuka M, Murata Y, Ishida R, Ohashi I, Hirata Y, Shibuya H (2003) MR imaging of the thyroid: correlation between apparent diffusion coefficient and thyroid gland scintigraphy. J Magn Reson Imaging 17:163–169PubMedCrossRef Tezuka M, Murata Y, Ishida R, Ohashi I, Hirata Y, Shibuya H (2003) MR imaging of the thyroid: correlation between apparent diffusion coefficient and thyroid gland scintigraphy. J Magn Reson Imaging 17:163–169PubMedCrossRef
24.
go back to reference Oertel YC, Oertel JE (1998) Diagnosis of malignant epithelial thyroid lesions: fine needle aspiration and histopathologic correlations. Ann Diagn Pathol 2:377–400PubMedCrossRef Oertel YC, Oertel JE (1998) Diagnosis of malignant epithelial thyroid lesions: fine needle aspiration and histopathologic correlations. Ann Diagn Pathol 2:377–400PubMedCrossRef
25.
go back to reference Anderson JR (2001) Tumours. I. General features, types and examples. In: Anderson JR (ed) Muir’s textbook of pathology, 20th edn. Edward Arnold, London, pp 12.1–12.49 Anderson JR (2001) Tumours. I. General features, types and examples. In: Anderson JR (ed) Muir’s textbook of pathology, 20th edn. Edward Arnold, London, pp 12.1–12.49
Metadata
Title
Diffusion-weighted MR imaging of thyroid nodules
Authors
Zulkif Bozgeyik
Sonay Coskun
A. Ferda Dagli
Yusuf Ozkan
Fatih Sahpaz
Erkin Ogur
Publication date
01-03-2009
Publisher
Springer-Verlag
Published in
Neuroradiology / Issue 3/2009
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-008-0494-3

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