title: Diagnostic value of diffusion-weighted MR imaging in thyroid disease: application in differentiating benign from malignant disease.
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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Diffusion-weighted MR imaging is a promising non-invasive method to differentiate malignancy in thyroid lesions.
authors.forename: Yingwei
authors.initials: Y
authors.lastname: Wu
authors.forename: Xiuhui
authors.initials: X
authors.lastname: Yue
authors.forename: Weiwen
authors.initials: W
authors.lastname: Shen
authors.forename: Yushan
authors.initials: Y
authors.lastname: Du
authors.forename: Ying
authors.initials: Y
authors.lastname: Yuan
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Tao
authors.forename: Cheuk Ying
authors.initials: CY
authors.lastname: Tang
mesh_terms: D000328:Adult; D000368:Aged; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D016606:Thyroid Nodule / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D055815:Young Adult
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