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Utility of Diffusion-Weighted Imaging in Differentiating Malignant From Benign Thyroid Nodules With Magnetic Resonance Imaging and Pathologic Correlation

Shi, Hai Feng MD; Feng, Qin MD; Qiang, Jin Wei MD, PhD; Li, Ruo Kun MD, PhD; Wang, Li MD; Yu, Jian Ping MD

Journal of Computer Assisted Tomography: July/August 2013 - Volume 37 - Issue 4 - p 505–510
doi: 10.1097/RCT.0b013e31828d28f0

Objective The objective of this study was to evaluate the role of magnetic resonance diffusion-weighted imaging (DWI) in differentiating malignant from benign thyroid nodules.

Methods The prospective study included 111 consecutive patients with solitary thyroid nodules (23 malignant and 88 benign nodules) who underwent DWI. The DWI signal and apparent diffusion coefficient (ADC) values of the nodules were determined and correlated with the histopathologic findings.

Results The majority (65%) of malignant thyroid nodules showed slightly hyperintense, and the majority (69%) of benign nodules were hyperintense on DWI (P < 0.01). The ADC values were lower in the thyroid cancer than in the adenoma and nodular goiter (P < 0.05). When the b factor was 500 s/mm2, an ADC value of 1.704 × 10−3 mm2/s can be threshold differentiating malignant from benign nodules, with 92% sensitivity, 88% specificity, and 87% accuracy. The higher cell density and more severe desmoplastic response were the causes of the lower ADC value of thyroid cancer.

Conclusion Diffusion-weighted imaging can be a promising noninvasive imaging to discriminate malignant from benign nodules.

From the *Department of Radiology, Jinshan Hospital, Shanghai Medical College, Fudan University, Shanghai; †Department of Radiology, Changzhi People’s Hospital, Shanxi; and ‡Departments of Pathology, and §Surgery, Jinshan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.

Received for publication November 28, 2012; accepted February 13, 2013.

Reprints: Jin Wei Qiang, MD, PhD, Department of Radiology, Jinshan Hospital, Shanghai Medical College, Fudan University, Shanghai, China (e-mail:

Grants were received from Shanghai Municipal Health Bureau (no. 2010-42) and Science and Technology Commission of Jinshan District, Shanghai (no. 375).

The authors have no conflict of interest to report.

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.