title: Diffusion-Weighted Imaging Using a Readout-Segmented, Multishot EPI Sequence at 3 T Distinguishes between Morphologically Differentiated and Undifferentiated Subtypes of Thyroid Carcinoma-A Preliminary Study.
abstract: BACKGROUND
  Thyroid carcinomas represent the most frequent endocrine malignancies. Recent studies were able to distinguish malignant from benign nodules of the thyroid gland with diffusion-weighted imaging (DWI). Although this differentiation is undoubtedly helpful, presurgical discrimination between well-differentiated and undifferentiated carcinomas would be crucial to define the optimal treatment algorithm. Therefore, the aim of this study was to investigate if readout-segmented multishot echo planar DWI is able to differentiate between differentiated and undifferentiated subtypes of thyroid carcinomas.
  
  
  METHODS
  Fourteen patients with different types of thyroid carcinomas who received preoperative DWI were included in our study. In all lesions, apparent diffusion coefficient (ADC)min, ADCmean, ADCmax, and D were estimated on the basis of region of interest measurements after coregistration with T1-weighted, postcontrast images. All tumors were resected and analyzed histopathologically. Ki-67 index, p53 synthesis, cellularity, and total and average nucleic areas were estimated using ImageJ version 1.48.
  
  
  RESULTS
  Analysis of variance revealed a statistically significant difference in ADCmean values between differentiated and undifferentiated thyroid carcinomas (P=.022). Spearman Rho calculation identified significant correlations between ADCmax and cell count (r=0.541, P=.046) as well as between ADCmax and total nuclei area (r=0.605, P=.022).
  
  
  CONCLUSIONS
  DWI can distinguish between differentiated and undifferentiated thyroid carcinomas.
authors.affiliation: Department of Neuroradiology, University Leipzig, Leipzig, Germany. Electronic address: stefan.Schob@medizin.uni-leipzig.de.
authors.forename: Stefan
authors.initials: S
authors.lastname: Schob
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Leipzig, Leipzig, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Voigt
authors.affiliation: Department of Radiology, McGill University Health Center, Montreal General Hospital, Quebec, Canada.
authors.forename: Lionel
authors.initials: L
authors.lastname: Bure
authors.affiliation: Department of Diagnostic Radiology, Martin Luther University Halle-Wittenberg, Leipzig, Germany.
authors.forename: Hans-Jonas
authors.initials: HJ
authors.lastname: Meyer
authors.affiliation: Department of Pathology, Martin Luther University Halle-Wittenberg, Leipzig, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Wickenhauser
authors.affiliation: Department of Diagnostic Radiology, Martin Luther University Halle-Wittenberg, Leipzig, Germany.
authors.forename: Curd
authors.initials: C
authors.lastname: Behrmann
authors.affiliation: Department of Pathology, University Leipzig, Leipzig, Germany.
authors.forename: Annekathrin
authors.initials: A
authors.lastname: Höhn
authors.affiliation: Department of General, Visceral and Vascular Surgery, Martin Luther University Halle-Wittenberg, Leipzig, Germany.
authors.forename: Paul
authors.initials: P
authors.lastname: Kachel
authors.affiliation: Department of General, Visceral and Vascular Surgery, Martin Luther University Halle-Wittenberg, Leipzig, Germany.
authors.forename: Henning
authors.initials: H
authors.lastname: Dralle
authors.affiliation: Department of Neuroradiology, University Leipzig, Leipzig, Germany.
authors.forename: Karl-Titus
authors.initials: KT
authors.lastname: Hoffmann
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Leipzig, Leipzig, Germany.
authors.forename: Alexey
authors.initials: A
authors.lastname: Surov