The Use of Dynamic Contrast-Enhanced Perfusion MRI in Differentiating Benign and Malignant Thyroid Nodules

Sakat, Muhammed Sedat; Sade, Recep; Kılıç, Korhan; Gözeler, Mustafa Sıtkı; Pala, Osman; Polat, Gökhan; Kantarcı, Mecit

doi:10.1007/s12070-018-1512-3

Cited by 9 publications

(3 citation statements)

References 17 publications

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“…Among the evaluated perfusion parameters, wash‐in rate with a cutoff value of 15.4/s (sensitivity: 87.9%, specificity: 90.0%) was adjudged as the best parameter for differentiating benign from malignant tumors. Similarly, Sakat et al 11 in their study on DCE‐MRI in differentiating benign from malignant thyroid nodules obtained significantly lower k trans and initial area under the enhancement curve values in malignant nodules; however, they did not establish any cutoff values.…”

Section: Discussionmentioning

confidence: 88%

“…In a landmark study done in 1994, Tsushima et al 10 had explored the role of dynamic MRI as a promising modality in characterizing salivary gland tumors and till the last decade major of the studies in head and neck have been published on this spectrum. However, in the current scenario, the bulk of work on DCE‐MRI has focused in identifying early locoregional recurrence; benign‐malignant differentiation of cervical lymph nodes, thyroid nodules, 11,12 and orbital masses 13 ; and for prediction of tumor response to treatment in patients with head and neck malignancies 14 . Angiogenesis, a hallmark of biologic aggressiveness, correlates well with tumor biology 15 with poorly differentiated neoplasms which are characterized by leaky and disorganized vessels forming the basis of benign‐malignant differentiation.…”

Section: Discussionmentioning

confidence: 99%

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Dynamic contrast‐enhanced magnetic resonance imaging for differentiating head and neck paraganglioma and schwannoma

et al. 2021

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Background and Purpose Morphological assessment with conventional magnetic resonance imaging (MRI) sequences has limited specificity to distinguish between paragangliomas and schwannomas. Assessing the differences in microvascular properties through pharmacokinetic parameters of dynamic contrast‐enhanced (DCE)‐MRI can provide additional information to aid in this differentiation. Materials and Methods A prospective study on MR characterization of neck masses was performed between January 2017 and March 2019 in our department, out of which 40 patients with head and neck paragangliomas (HNPGLs) (33 lesions) and schwannomas (15 lesions) were included in this analysis. MR perfusion using dynamic axial T1WI fat suppressed fast spoiled gradient recalled sequence with parallel imaging was performed in all the patients, in addition to single‐shot turbo spin‐echo axial diffusion weighted imaging (DWI) and routine MRI. ROI‐based method was used to obtain signal‐time curves, permeability measurements, and mean apparent diffusion coefficient (ADC) to differentiate paragangliomas from schwannomas. Statistical analysis was done to assess the significance and establish a cutoff to distinguish between the two entities. The available images of DOTANOC PET/CT (34 lesions) were analyzed retrospectively. Correlations between the perfusion, diffusion, and molecular PET/CT parameters were done. Results Paragangliomas had a higher wash‐in rate, wash‐out rate, Ktrans, Kep, and Vp (p < 0.001); while schwannomas had a higher relative enhancement (p < 0.012), time to peak, time of onset, brevity of enhancement, and Ve (p < 0.001). Among the perfusion parameters, Kep (area under curve (AUC) 0.994) and Vp (AUC 0.992) were found to have the highest diagnostic value. In diffusion‐weighted imaging, paragangliomas had a lower mean ADC compared to schwannomas (p < 0.001). The SUVmax and SUVmean were significantly associated with Ktrans, Kep, and Vp in paragangliomas. Conclusion DCE‐MRI in addition to DWI‐MRI can accurately distinguish HNPGL from schwannoma and may replace the need for any additional imaging and preoperative biopsy in most cases.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Dynamic contrast‐enhanced magnetic resonance imaging for differentiating head and neck paraganglioma and schwannoma

et al. 2021

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“…In perfusion imaging which uses high-pressure injection, an injection speed of 3 to 5 mL/s is often used to ensure the perfusion quality. [ 6 , 7 ] This high-speed, large-volume direct injection method has a high probability of causing damage to the vein. Pulse flushing is a periodic operation of push-stop, which generates positive and negative pressure in the catheter cavity to form turbulence.…”

Section: Introductionmentioning

confidence: 99%

Flushing effect of micro-bolus pulse injection and its potential impact on peripheral veins under hemostasis

Li,

Wang,

et al. 2023

Medicine

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To explore the feasibility of using micro-bolus pulse injection method to reduce the dilution effect of pipeline on high concentration injection, and to understand low liquid volume bolus injection based on low injection speed. Using a programmable pulse injection pump, a 25-cm – long pipeline containing water-soluble fluorescent agent was flushed using different volumes of bolus, and the time spent for the complete disappearance of the fluorescent agent was recorded to evaluate the flushing efficiency. The finite element simulation of 2-phase flow was carried out using computational fluid dynamics (CFD) technology, and the difference of shear rate and pressure distribution in the vein of pulse injection and direct injection of bolus under hemostasis was compared and simulated. Micro-bolus pulse flushing has advantages in completing perfusion imaging applications, such as small volume imaging agent injection. Compared with non-pulse injection, the effective flushing volume decreases by 49.7%, the average injection speed decreases by 56%, and the maintenance time of high shear rate is shorter when using micro-bolus pulse injection. The impact of micro-bolus pulse injection on the vein can achieve the same or even lower negative effects as other injection methods after increasing the hemostatic distance to 100 mm. In the case of bolus injection requiring high concentration and small volume, such as for radiopharmaceutical dynamic imaging, the application of micro-bolus pulse injection is an effective way to overcome the dilution phenomenon of the imaging agent in the pipeline. During hemostasis, the micro-bolus pulse injection needs to control a longer hemostasis distance to reduce the potential impact on peripheral veins.

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Non-invasive Imaging Biomarkers of Thyroid Nodules with Indeterminate Cytology

Noortman

Koster

Velden

et al. 2023

Integrated Diagnostics and Theranostics of Thyroid Diseases

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Stratified by ultrasonography and fine-needle aspiration cytology, indeterminate nodules are lesions with an intermediate risk of being malignant (approximately 25%). Diagnostic resection of half the thyroid gland provides the true nature of these lesions but at the cost of 75% of the patients being futilely operated. In case a malignancy is found, a second surgery to remove the whole thyroid gland is often necessary. Different approaches either on cytological material or using imaging have been investigated to further stratify these lesions. This chapter reviewed biomarkers obtained using conventional as well as artificial intelligence-based non-invasive imaging strategies for the differentiation of thyroid nodules with indeterminate cytology. An overview of the abilities of different tests to differentiate between benign and malignant nodules was provided, taking into account the clinical readiness and cost-effectiveness.

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The Use of Dynamic Contrast-Enhanced Perfusion MRI in Differentiating Benign and Malignant Thyroid Nodules

Cited by 9 publications

References 17 publications

Dynamic contrast‐enhanced magnetic resonance imaging for differentiating head and neck paraganglioma and schwannoma

Dynamic contrast‐enhanced magnetic resonance imaging for differentiating head and neck paraganglioma and schwannoma

Flushing effect of micro-bolus pulse injection and its potential impact on peripheral veins under hemostasis

Non-invasive Imaging Biomarkers of Thyroid Nodules with Indeterminate Cytology

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