E-ISSN 1305-3612
Head and Neck Imaging - Original Article
Efficacy of apparent diffusion coefficient in predicting aggressive histological features of papillary thyroid carcinoma
Bin Song 1 ,  
Hao Wang 1 ,  
Ran Wei 1 ,  
1 Department of Radiology, Zhongshan Hospital, Fudan University School of Medicine, Shanghai, China  
2 Department of Pathology, Zhongshan Hospital, Fudan University School of Medicine, Shanghai, China  
3 Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai, China  
Diagn Interv Radiol ; : -

Abstract

PURPOSE: To evaluate preoperative diffusion-weighted magnetic resonance imaging (DWI-MRI) for predicting aggressive histological features in papillary thyroid cancer (PTC).


METHODS
: This prospective study included 141 PTC patients, who underwent DW-MRI prior to thyroidectomy; 88 patients with 88 PTC lesions were finally analyzed. Multiple comparisons of mean and minimum apparent diffusion coefficient (ADC) values (ADCmean and ADCmin) and ADC of the solid component (ADCsolid) between the lowly aggressive PTC, highly aggressive PTC without hobnail, and hobnail variant PTC groups were performed by one-way ANOVA or the Welch test. The nonparametric Kruskal-Wallis H-test was used to assess lesion size differences. Receiver-operating characteristic (ROC) curve analysis was also performed.


RESULTS
: ADCmean, ADCmin and ADCsolid values in the lowly aggressive PTC group (1.35±0.20×10-3 mm2/s, 1.10±0.17×10-3 mm2/s and 1.26±0.23×10-3 mm2/s, respectively) were found to be significantly (P=0.003, P<0.001,and P<0.001, respectively) higher than in the highly aggressive PTC without hobnail group (1.16±0.17×10-3 mm2/s, 0.88±0.16×10-3 mm2/s and 1.04±0.17×10-3 mm2/s, respectively). No significant differences for the ADCmean, ADCmin and ADCsolid were observed between the lowly aggressive and hobnail variant PTC groups (all P>0.05). Lesion sizes in the hobnail variant PTC group (2.19±1.21 cm) was significantly elevated (P<0.001) compared with the lowly aggressive PTC group (0.93±0.37 cm). Areas under the curves (AUCs) for ADCmean, ADCmin and ADCsolid between the lowly aggressive PTC and highly aggressive PTC group without hobnail were 0.758, 0.851 and 0.787, respectively. The AUC for size between the lowly aggressive and hobnail variant PTC group was 0.896.


CONCLUSION
: ADCmin from DWI could potentially provide quantitative information to differentiate lowly aggressive PTC from highly aggressive PTC lesions without hobnail variants.

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