Skip to main content

Certainty of pretreatment apparent diffusion coefficient in the characterization of thyroid gland pathologies

Abstract

Introduction

One of the most recent techniques in imaging tumors is the diffusion-weighted MRI. It provides information regarding the metabolic, molecular, and pathophysiological aspects of tumors, especially thyroid gland cancer. Diffusion-weighted imaging (DWI) has also been proposed as a sensitive marker for monitoring treatment response in head and neck cancers. The biophysical mechanism of DWI is based on the translational motion of water molecules in tissues. The magnitude of this motion is characterized by its apparent diffusion coefficient (ADC) values.

Objective

The aim of the present study was to evaluate the certainty of ADC value in differentiating between benign and malignant thyroid lesions.

Materials and methods

Neck MRI with several sequences including DWI in the axial plane were carried out for 49 patients who presented with thyroid masses either benign or malignant. ADC maps were calculated by using the MRI machine software.

Results

A total of 49 patients (77.6%) were included in the present study. There were 11 men (22.4%) and 38 women patients (77.6%), with a mean age of 44.4 years. The lesions were benign in 31 cases (63.3%) and malignant in 18 cases (36.7%). The ADC values were significantly different (P<0.001) between benign and malignant lesions.

Conclusion

ADC value is a promising noninvasive imaging tool that can be used for characterization and differentiation of thyroid nodules.

References

  1. Reading CC, Charboneau JW, Hay ID, Sebo TJ. Sonography of thyroid nodules: a ‘classic pattern’ diagnostic approach. Ultrasound Q 2005; 21:157–165.

    PubMed  Google Scholar 

  2. Weber AL, Randolph G, Aksoy FG. The thyroid and parathyroid glands. CT and MR imaging and correlation with pathology and clinical findings. Radiol Clin North Am 2000; 38:1105–1129.

    CAS  Google Scholar 

  3. Tan GH, Gharib H, Reading CC. Solitary thyroid nodule. Comparison between palpation and ultrasonography. Arch Intern Med 1995; 155: 2418–2423.

    CAS  PubMed  Google Scholar 

  4. Solbiati L, Osti V, Cova L, Tonolini M. Ultrasound of thyroid, parathyroid glands and neck lymph nodes. Eur Radiol 2001; 11:2411–2424.

    CAS  PubMed  Google Scholar 

  5. Gooding G. Sonography of the thyroid and parathyroid. Radiol Clin North Am 1993; 31:967–989.

    CAS  PubMed  Google Scholar 

  6. Bartolotta TV, Midiri M, Galia M, Runza G, Attard M, Savoia G, et al. Qualitative and quantitative evaluation of solitary thyroid nodules with contrast-enhanced ultrasound: initial results. Eur Radiol 2006; 16:2234–2241.

    PubMed  Google Scholar 

  7. Yousem DM. Parathyroid and thyroid imaging. Neuroimaging Clin N Am 1996; 6:435–459.

    CAS  PubMed  Google Scholar 

  8. Sahin M, Guvener N, Ozer F, et al. Thyroid cancer in hyperthyroidism: incidence rate and value of ultrasound-guided fine-needle aspiration biopsy in this patient group. J Endocrinol Invest 2005; 28:815–818.

    CAS  PubMed  Google Scholar 

  9. Okamoto T, Yamashita T, Harasawa A. Test performance of three diagnostic procedures in evaluating thyroid nodules: physical examination, ultrasonography and fine needle aspiration cytology. Endocr J 1994; 41: 243–247.

    CAS  PubMed  Google Scholar 

  10. Altavilla G, Pascale M, Nenci I. Fine needle aspiration cytology of thyroid gland diseases. Acta Cytol 1990; 34:251–256.

    CAS  PubMed  Google Scholar 

  11. Gharib H, Goellner JR. Fine-needle aspiration biopsy of the thyroid: an appraisal. Ann Intern Med 1993; 118:282–289.

    CAS  PubMed  Google Scholar 

  12. Schechter NR, Gillenwater AM, Byers RM, Garden AS, Morrison WH, Nguyen LN, et al. Can positron emission tomography improve the quality of care for head-and-neck cancer patients?. Int J Radiat Oncol Biol Phys 2001; 51:4–9.

    CAS  PubMed  Google Scholar 

  13. Schwartz DL, Rajendran J, Yueh B, Coltrera M, Anzai Y, Krohn K, Eary J. Staging of head and neck squamous cell cancer with extended-field FDG-PET. Arch Otolaryngol Head Neck Surg 2003; 129:1173–1178.

    PubMed  Google Scholar 

  14. Yao M, Smith RB, Graham MM, Hoffman HT, Tan H, Funk GF, et al. The role of FDG PET in management of neck metastasis from head-and-neck cancer after definitive radiation treatment. Int J Radiat Oncol Biol Phys 2005; 63:991–999.

    PubMed  Google Scholar 

  15. McCollum AD, Burrell SC, Haddad RI, et al. Positron emission tomography with 18F-fluorodeoxyglucose to predict pathologic response after induction chemotherapy and definitive chemoradiotherapy in head and neck cancer. Head Neck 2004; 26:890–896.

    PubMed  Google Scholar 

  16. Mukherji SK, Schiro S, Castillo M, Kwock L, Muller KE, Blackstock W. Proton MR spectroscopy of squamous cell carcinoma of the extracranial head and neck: in vitro and in vivo studies. Am J Neuroradiol 1997; 18:1057–1072.

    CAS  PubMed  Google Scholar 

  17. Star-Lack JM, Adalsteinsson E, Adam MF, et al. In vivo1h MR spectroscopy of human head and neck lymph node metastasis and comparison with oxygen tension measurements. Am J Neuroradiol 2000; 21:183–193.

    CAS  PubMed  Google Scholar 

  18. Kim S, Loevner L, Quon H, Sherman E, Weinstein G, Kilger A, Poptani H. Diffusion-weighted magnetic resonance imaging for predicting and detecting early response to chemoradiation therapy of squamous cell carcinomas of the head and neck. Clin Cancer Res 2009; 15:986–994.

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Padhani AR, Liu G, Koh DM, Chenevert TL, Thoeny HC, Takahara T, et al. Diffusion-weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations. Neoplasia 2009; 11:102–125.

    CAS  PubMed  PubMed Central  Google Scholar 

  20. Wang J, Takashima S, Takayama F, Kawakami S, Saito A, Matsushita T, et al. Head and neck lesions: characterization with diffusion-weighted echo-planar MR imaging. Radiology 2001; 220:621–630.

    CAS  PubMed  Google Scholar 

  21. Tezuka M, Murata Y, Ishida R, Ohashi I, Hirata Y, Shibuya H. MR imaging of the thyroid: correlation between apparent diffusion coefficient and thyroid gland scintigraphy. J Magn Reson Imaging 2003; 17:163–169.

    PubMed  Google Scholar 

  22. Lemaire L, Howe FA, Rodrigues LM, Griffiths JR. Assessment of induced rat mammary tumour response to chemotherapy using the apparent diffusion coefficient of tissue water as determined by diffusion-weighted 1H-NMR spectroscopy in vivo. MAGMA 1999; 8:20–26.

    CAS  PubMed  Google Scholar 

  23. Mardor Y, Roth Y, Ochershvilli A, Spiegelmann R, Tichler T, Daniels D, et al. Pretreatment prediction of brain tumors’ response to radiation therapy using high b-value diffusion-weighted MRI. Neoplasia 2004; 6:136–142.

    PubMed  PubMed Central  Google Scholar 

  24. Dzik-Jurasz A, Domenig C, George M, Wolber J, Padhani A, Brown G, Doran S. Diffusion MRI for prediction of response of rectal cancer to chemoradiation. Lancet 2002; 360:307–308.

    PubMed  Google Scholar 

  25. McVeigh PZ, Syed AM, Milosevic M, Fyles A, Haider MA. Diffusion-weighted MRI in cervical cancer. Eur Radiol 2008; 18:1058–1064.

    PubMed  Google Scholar 

  26. Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, et al. American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009; 19:1167–1214.

    Google Scholar 

  27. Soto GD, Halperin I, Squarcia M, Lomeña F, Domingo MP. Update in thyroid imaging. The expanding world of thyroid imaging and its translation to clinical practice. Hormones (Athens) 2010; 9:287–298.

    Google Scholar 

  28. Erdem G, Erdem T, Muammer H, Mutlu DY, Firat AK, Sahin I, Alkan A. Diffusion-weighted images differentiate benign from malignant thyroid nodules. J Magn Reson Imaging 2010; 31:94–100.

    PubMed  Google Scholar 

  29. Koh DM, Padhani AR. Diffusion-weighted MRI: a new functional clinical technique for tumour imaging. Br J Radiol 2006; 79:633–635.

    PubMed  Google Scholar 

  30. Ginat DT, Mangla R, Yeaney G, Johnson M, Ekholm S. Diffusion-weighted imaging for differentiating benign from malignant skull lesions and correlation with cell density. Am J Roentgenol 2012; 198:597–601.

    Google Scholar 

  31. Habermann CR, Arndt C, Graessner J, Diestel L, Petersen KU, Reitmeier F, et al. Diffusion-weighted echo-planar MR imaging of primary parotid gland tumors: is a prediction of different histologic subtypes possible?. Am J Neuroradiol 2009; 30:591–596.

    CAS  PubMed  Google Scholar 

  32. Razek AA, Sadek AG, Kombar OR, Elmahdy TE, Nada N. Role of apparent diffusion coefficient values in differentiation between malignant and benign solitary thyroid nodules. Am J Neuroradiol 2008; 29:563–568.

    PubMed  Google Scholar 

  33. Razek AA, Gaballa G, Elhawarey G, et al. Characterization of pediatric head and neck masses with diffusion-weighted MR imaging. Eur Radiol 2009; 19:201–208.

    PubMed  Google Scholar 

  34. White ML, Zhang Y, Robinson RA. Evaluating tumors and tumor like lesions of the nasal cavity, the paranasal sinuses, and the adjacent skull base with diffusion-weighted MRI. J Comput Assist Tomogr 2006; 30:490–495.

    PubMed  Google Scholar 

  35. Anderson JR, Tumors I. General features, types and examples. In: Levison DA, Reid R, Burt AD, Harrison DJ, Fleming S, eds. Muir’s textbook of pathology 14th edLondon: Hodder Arnold Publication; 2008;127–156.

    Google Scholar 

  36. Thoeny HC, De Keyzer F, Chen F, Ni Y, Landuyt W, Verbeken EK, et al. Diffusion-weighted MR imaging in monitoring the effect of a vascular targeting agent on rhabdomyosarcoma in rats. Radiology 2005; 234:756–764.

    PubMed  Google Scholar 

  37. Byun WM, Shin SO, Chang Y, Lee SJ, Finsterbusch J, Frahm J. Diffusion-weighted MR imaging of metastatic disease of the spine: assessment of response to therapy. Am J Neuroradiol 2002; 23:906–912.

    PubMed  Google Scholar 

  38. Chen CY, Li CW, Kuo YT, et al. Early response of hepatocellular carcinoma to trans catheter arterial chemoembolization: choline levels and MR diffusion constants–initial experience. Radiology 2006; 239:448–456.

    PubMed  Google Scholar 

  39. MacSween RNM, Whaley K. Muir’s textbook of pathology. 13th ed. London Hodder & Stoughton 1992.

  40. Sumi M, Nakamura T. Diagnostic importance of focal defects in the apparent diffusion coefficient-based differentiation between lymphoma and squamous cell carcinoma nodes in the neck. Eur Radiol 2009; 19:975–981.

    PubMed  Google Scholar 

  41. Razek AA, Megahed AS, Denewer A, Motamed A, Tawfik A, Nada N. Role of diffusion-weighted magnetic resonance imaging in differentiation between the viable and necrotic parts of head and neck tumors. Acta Radiol 2008; 49:364–370.

    PubMed  Google Scholar 

  42. Abdel Razek A, Mossad A, Ghonim M. Role of diffusion-weighted MR imaging in assessing malignant versus benign skull-base lesions. Radiol Med 2011; 116:125–132.

    CAS  PubMed  Google Scholar 

  43. Delorme S, Knopp MV. Non-invasive vascular imaging: assessing tumour vascularity. Eur Radiol 1998; 8:517–527.

    CAS  PubMed  Google Scholar 

  44. Taha MS, Amir M, Hassan O, Sabra R, Taha T, Riad MA. Pre-treatment apparent diffusion coefficient mapping: differentiation of benign from malignant laryngeal lesions. J Laryngol Otol 2015; 129:57–62.

    CAS  PubMed  Google Scholar 

  45. Taha MS, El Fiky LM, Taha TM, Sabra RM, Youssef TA, Nada IM. Utility of apparent diffusion coefficient in characterization of different sinonasal pathologies. Am J Rhinol Allergy 2014; 28:181–186.

    PubMed  Google Scholar 

  46. Schueller-Weidekamm C, Kaserer K, Schueller G, Scheuba C, Ringl H, Weber M, et al. Can quantitative diffusion-weighted MR imaging differentiate benign and malignant cold thyroid nodules? Initial results in 25 patients. Am J Neuroradiol 2009; 30:417–422.

    CAS  PubMed  Google Scholar 

  47. Schueller-Weidekamm C, Schueller G, Kaserer K, Scheuba C, Ringl H, Weber M, et al. Diagnostic value of sonography, ultrasound-guided fine-needle aspiration cytology, and diffusion-weighted MRI in the characterization of cold thyroid nodules. Eur J Radiol 2010; 73:538–544.

    PubMed  Google Scholar 

  48. Wu Y, Yue X, Shen W, Du Y, Yuan Y, Tao X, Tang CY. Diagnostic value of diffusion-weighted MR imaging in thyroid disease: application in differentiating benign from malignant disease. BMC Med Imaging 2013; 13:23.

    CAS  PubMed  PubMed Central  Google Scholar 

  49. Katz JF, Kane RA, Reyes J, Clarke MP, Hill TC. Thyroid nodules: sonographic-pathologic correlation. Radiology 1984; 151:741–745.

    CAS  PubMed  Google Scholar 

  50. Chawla S, Kim S, Wang S, Poptani H. Diffusion-weighted imaging in head and neck cancers. Future Oncol 2009; 5:959–975.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ahmed G. Khafagy.

Additional information

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Abd-Alhamid, T., Khafagy, A.G., Al Sersy, H. et al. Certainty of pretreatment apparent diffusion coefficient in the characterization of thyroid gland pathologies. Egypt J Otolaryngol 33, 495–501 (2017). https://doi.org/10.4103/1012-5574.206019

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/1012-5574.206019

Keywords