Non-invasive Amide Proton Transfer Imaging and ZOOM Diffusion-Weighted Imaging in Differentiating Benign and Malignant Thyroid Micronodules

Abstract

Background: Pre-operative non-invasive differentiation of benign and malignant thyroid nodules is difficult for doctors. This study aims to determine whether amide proton transfer (APT) imaging and zonally oblique multi-slice (ZOOM) diffusion-weighted imaging (DWI) can provide increased accuracy in differentiating benign and malignant thyroid nodules.Methods: This retrospective study was approved by the institutional review board and included 60 thyroid nodules in 50 patients. All of the nodules were classified as malignant (n = 21) or benign (n = 39) based on pathology. It was meaningful to analyze the APT and apparent diffusion coefficient (ADC) values of the two groups by independent t-test to identify the benign and malignant thyroid nodules. The relationship between APT and ZOOM DWI was explored through Pearson correlation analysis. The diagnostic efficacy of APT and ZOOM DWI in determining if thyroid nodules were benign or malignant was compared using receiver operating characteristic (ROC) curve analysis.Results: The mean APTw value of the benign nodules was 2.99 ± 0.79, while that of the malignant nodules was 2.14 ± 0.73. Additionally, there was a significant difference in the APTw values of the two groups (P < 0.05). The mean ADC value of the benign nodules was 1.84 ± 0.41, and was significantly different from that of the malignant nodules, which was 1.21 ± 0.19 (P < 0.05). Scatter point and Pearson test showed a moderate positive correlation between the APT and ADC values (P < 0.05). The ROC curve showed that the area under the curve (AUC) value of ZOOM DWI (AUC = 0.937) was greater than that of APT (AUC = 0.783) (P = 0.028).Conclusion: APT and ZOOM DWI imaging improved the accuracy of distinguishing between benign and malignant thyroid nodules. ZOOM DWI is superior to APTw imaging (Z = 2.198, P < 0.05).

Comparing the clinical utility of single-shot, readout-segmented and zoomit echo-planar imaging in diffusion-weighted imaging of the kidney at 3 T

“…Consequently, the intra- and inter-observer agreements with RT-DWI and NT-DWI were lower than with Z-DWI. Previous studies have shown that Z-DWI has obvious advantages in cervical cancer 28 , thyroid micronodules 29 , cervical spinal cord 30 , etc. It enables clearer identification of lesions and reduction of image artifacts.…”

T1 mapping and reduced field‐of‐view DWI at 3.0 T MRI for differentiation of thyroid papillary carcinoma from nodular goiter

“…To date, many studies have proven that the use of functional MRI imaging sequences, such as amide proton transfer imaging, intravoxel incoherent motion and diffusion kurtosis imaging (DKI) have certain significance in the differential diagnosis of benign and malignant thyroid lesions (Liu et al, 2018; Shi et al, 2017; Tan et al, 2019). At present, NG is a common benign thyroid disease.…”

“…Therefore, it is less sensitive to the inhomogeneity of the magnetic field. And many previous studies have proven that as a novel imaging technology, rFOV‐DWI has great diagnostic value in differentiating benign and malignant thyroid lesions (Hao et al, 2016; Liu et al, 2018). As a reverse recovery sequence with multiple TI values, T1 mapping can accurately and quantitatively determine the T1 value of lesions, such as internal tissue information including water content and fibrosis (Nacif et al, 2011).…”

Applying Amide Proton Transfer-Weighted Imaging (APTWI) to Distinguish Papillary Thyroid Carcinomas and Predominantly Solid Adenomatous Nodules: Comparison With Diffusion-Weighted Imaging

“…We previously reported on a study about patients with thyroid tumors that showed the feasibility of performing APTw imaging in the neck. The results showed that the APTw values of malignant nodules of the thyroid are lower than that of benign nodules, which is different from other tumors (16). However, thyroid tumors are prone to cystic change (17), which have a significant influence on the measurement of APTw values.…”