A Comparative Analysis of DWI and Ultrasound in Thyroid Nodules

Abstract Background Diffusion weighted imaging and ultrasound are commonly used methods to examine thyroid nodules, but their comparative value is rarely studied. To evaluate the value of diffusion weighted imaging and ultrasound in differentiing benign and malignant thyroid nodules Methods A total of 100 patients with 137 nodules were enrolled. who underwent both diffusion weighted imaging and ultrasound before operation. T1 and T2 signal intensity ratio (SIR) of each thyroid nodule was calculated by measuring the mean signal intensity divided by that of paraspinal muscle. The value of ADC,signal intensity ratio (SIR) of benign and malignant thyroid nodules were analyzed by two independent sample t test. The sensitivity, specificity and accuracy of DWI and ultrasound were compared and analyzed by chi-square test. Results There was no significant difference in signal intensity ratio between benign and malignant thyroid nodules. The ADC value had significant difference. When the threshold value was 1.12 ×10-3 mm2/s, the maximum area under the curve was 0.944,The sensitivity, specificity and accuracy were 84.9%, 92.2% and 87.6% respectively. The sensitivity and specificity of ultrasound diagnosis were 90.1%, 80.4% and 86.9% respectively. Conclusion Ultrasound has high sensitivity in differentiating benign and malignant thyroid nodules, and ADC value has high specificity in differentiating thyroid nodules, but there is no statistical difference in sensitivity and specificity between the two. DWI and Ultrasound have their own advantages in differentiating benign and malignant thyroid nodules.

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A Comparative Analysis of Diffusion-weighted Imaging and Ultrasound in Thyroid Nodules

10.21203/rs.2.12244/v2 ◽

2019 ◽

Author(s):

Weidan Kong ◽

Xiuhui Yue ◽

Jiliang Ren ◽

xiaofeng tao

Keyword(s):

Signal Intensity ◽

Diffusion Weighted Imaging ◽

Thyroid Nodules ◽

Area Under The Curve ◽

High Sensitivity ◽

High Specificity ◽

Adc Value ◽

Diffusion Weighted ◽

Significant Difference ◽

Sensitivity Specificity

Abstract Background: Diffusion-weighted imaging (DWI) and ultrasound are commonly used methods to examine thyroid nodules, but their comparative value is rarely studied. We evaluated the utility of DWI and ultrasound in differentiating benign and malignant thyroid nodules. Methods: A total of 100 patients with 137 nodules who underwent both DWI and ultrasound before operation were enrolled. The T1 and T2 signal intensity ratio (SIR) of each thyroid nodule was calculated by measuring the mean signal intensity divided by that of paraspinal muscle. The apparent diffusion coefficient (ADC) value and the SIR of benign and malignant thyroid nodules were analyzed by two-sample independent t tests. The sensitivity, specificity, and accuracy of DWI and ultrasound were compared with chi-square tests. Results: There was no significant difference in the SIR between benign and malignant thyroid nodules. The ADC value was significantly different. At the threshold value was 1.12 × 10 -3 mm 2 /s, the maximum area under the curve was 0.944. The sensitivity, specificity, and accuracy were 84.9%, 92.2%, and 87.6% respectively. The corresponding values of ultrasound diagnosis were 90.1%, 80.4%, and 86.9%. Conclusions: Ultrasound has high sensitivity in differentiating benign and malignant thyroid nodules, and the ADC value has high specificity, but there is no statistical difference in sensitivity or specificity between the two modalities. DWI and ultrasound each have their own advantages in differentiating benign and malignant thyroid nodules. Keywords Thyroid nodules, Ultrasound, Diffusion-weighted imaging

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A comparative analysis of diffusion-weighted imaging and ultrasound in thyroid nodules

BMC Medical Imaging ◽

10.1186/s12880-019-0381-x ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Weidan Kong ◽

Xiuhui Yue ◽

Jiliang Ren ◽

Xiaofeng Tao

Keyword(s):

Signal Intensity ◽

Diffusion Weighted Imaging ◽

Thyroid Nodules ◽

Area Under The Curve ◽

High Sensitivity ◽

High Specificity ◽

Adc Value ◽

Diffusion Weighted ◽

Significant Difference ◽

Sensitivity Specificity

Abstract Background Diffusion-weighted imaging (DWI) and ultrasound are commonly used methods to examine thyroid nodules, but their comparative value is rarely studied. We evaluated the utility of DWI and ultrasound in differentiating benign and malignant thyroid nodules. Methods A total of 100 patients with 137 nodules who underwent both DWI and ultrasound before operation were enrolled. The T1 and T2 signal intensity ratio (SIR) of each thyroid nodule was calculated by measuring the mean signal intensity divided by that of paraspinal muscle. The apparent diffusion coefficient (ADC) value and the SIR of benign and malignant thyroid nodules were analyzed by two-sample independent t tests. The sensitivity, specificity, and accuracy of DWI and ultrasound were compared with chi-square tests. Results There was no significant difference in the SIR between benign and malignant thyroid nodules. The ADC value was significantly different. At the threshold value was 1.12 × 10− 3 mm2/s, the maximum area under the curve was 0.944. The sensitivity, specificity, and accuracy were 84.9, 92.2, and 87.6% respectively. The corresponding values of ultrasound diagnosis were 90.1, 80.4, and 86.9%. Conclusions Ultrasound has high sensitivity in differentiating benign and malignant thyroid nodules, and the ADC value has high specificity, but there is no statistical difference in sensitivity or specificity between the two modalities. DWI and ultrasound each have their own advantages in differentiating benign and malignant thyroid nodules.

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MRI findings and demographics of elastofibroma dorsi: assessment of diffusion-weighted imaging and contrast enhancement patterns

Acta Radiologica ◽

10.1177/0284185117732099 ◽

2017 ◽

Vol 59 (6) ◽

pp. 709-715 ◽

Cited By ~ 2

Author(s):

Maho Tsubakimoto ◽

Tsuneo Yamashiro ◽

Nanae Tsuchiya ◽

Masahiro Okada ◽

Hiroki Maehara ◽

...

Keyword(s):

Contrast Enhancement ◽

Signal Intensity ◽

Diffusion Weighted Imaging ◽

Enhancement Pattern ◽

Mri Findings ◽

Adc Value ◽

Diffusion Restriction ◽

Diffusion Weighted ◽

Elastofibroma Dorsi ◽

Significant Difference

Background Elastofibroma dorsi is a rare pseudotumoral lesion. Thus, there is no report of magnetic resonance imaging (MRI) findings that investigates multiple patients particularly with respect to diffusion-weighted imaging (DWI) findings and contrast enhancement patterns. Purpose To describe the imaging findings of elastofibroma on MRI, particularly DWI findings and contrast enhancement patterns, and to further investigate patient demographics. Material and Methods Forty-four patients with elastofibroma that underwent MRI were enrolled in this retrospective study. All images were evaluated by two radiologists to visually assess the signal intensity for each sequence. Enhanced elastofibromas were classified into four categories to assess the enhancement pattern. Differences in gender and laterality were also assessed statistically. Results An equal number of men and women were included (n = 22 each). There was no significant difference in laterality ( P = 0.783). All lesions (73 lesions) had low signal intensity on both T1-weighted (T1W) and T2-weighted (T2W) images: heterogeneous in 56, homogeneous in 17. None of the 41 lesions with DWI had true abnormal diffusion restriction. The average ADC value was 1.36 × 10–3 ± 0.29 mm2/s. All 31 lesions that had contrast-enhanced MRI were classified according to enhancement pattern: homogeneous (three lesions, 9.7%); heterogeneous (15 lesions, 48.4%); streak-like (three lesions, 9.7%); and rim-like (ten lesions, 32.2%). Conclusion There were no statistically significant differences in gender or laterality. Elastofibroma showed homogeneous to heterogeneous low signal intensity on T1W and T2W images. No lesion showed abnormal diffusion restriction, and all lesions demonstrated enhancement on MRI.

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Role of Quantitative Diffusion-Weighted Imaging in Differentiating Benign and Malignant Orbital Masses

Indian Journal of Radiology and Imaging ◽

10.1055/s-0041-1730120 ◽

2021 ◽

Author(s):

Preeti Mundhada ◽

Sudarshan Rawat ◽

Ullas Acharya ◽

Dhananjay Raje

Keyword(s):

Roc Curve ◽

Diffusion Weighted Imaging ◽

Care Hospital ◽

Adc Value ◽

Diffusion Weighted ◽

Significant Difference ◽

Orbital Masses ◽

Adc Values ◽

Orbital Lesions

Abstract Aim To determine the role of diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) values in differentiating benign and malignant orbital masses. Materials and Methods After obtaining institutional ethical board approval and informed consent from all patients, an observational study was done for a period of 24 months in the radiology department of a tertiary care hospital in South India. Conventional magnetic resonance imaging and DWI using a 3T scanner was done for all patients with suspected orbital mass lesion. ADC value and clinicohistopathological correlation were studied for every patient. Chi-square test was used to compare the signal characteristics of DWI and ADC maps between benign and malignant lesions. A comparison of mean ADC values for benign and malignant masses was performed using Student’s t-test for independent samples. The cut-off value for ADC was obtained using the receiver operating characteristic (ROC) curve. Results Of 44 patients with orbital lesions, 70% were benign and 30% were malignant. There was a significant difference in the mean ADC values of benign and malignant orbital masses. Using ROC curve analysis, an optimal ADC threshold of 1.26 × 10−3 mm2/s was calculated for the prediction of malignancy with 100% sensitivity, 80.65% specificity, and 86.36% accuracy (95% confidence interval: 0.872, 1.00, p < 0.0001). Two ADC thresholds were used to characterize the orbital masses with more than 90% confidence. Conclusion Quantitative assessment of ADC is a useful noninvasive diagnostic tool for differentiating benign and malignant orbital masses. Malignant orbital lesions demonstrate significantly lower ADC values as compared with benign lesions.

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The role of magnetic resonance cholangiopancreatography and diffusion-weighted imaging for the differential diagnosis of obstructive biliary disorders

South African Journal of Radiology ◽

10.4102/sajr.v21i1.1193 ◽

2017 ◽

Vol 21 (1) ◽

Author(s):

Zeynep Cetiner-Alpay ◽

Fatma Kulali ◽

Aslihan Semiz-Oysu ◽

Yasar Bukte ◽

Kamil Ozdil

Keyword(s):

Magnetic Resonance ◽

Sensitivity And Specificity ◽

Gold Standard ◽

Diffusion Weighted Imaging ◽

Magnetic Resonance Cholangiopancreatography ◽

Malignant Tumours ◽

Diagnostic Efficacy ◽

Diffusion Weighted ◽

Sensitivity Specificity ◽

And Diffusion

Background: Although endoscopic retrograde cholangiopancreatography (ERCP) is accepted as the gold standard, there is a place for magnetic resonance cholangiopancreatography (MRCP) and diffusion-weighted imaging (DWI) in the diagnosis of obstructive biliary disorders.Aim: To compare the findings of MRCP with ERCP in patients with obstructive biliary disorders and to investigate the diagnostic efficacy of MRCP combined with DWI.Study design: Retrospective, analytic, cross-sectional study.Methods: The MRCP images of 126 patients who underwent both MRCP and ERCP owing to biliary obstruction were reviewed. Nine patients were excluded because of incomplete diagnostic workup or a long period (>3 months) between MRCP and ERCP. Ninety-two patients underwent DWI, which was also evaluated. The sensitivity, specificity and accuracy of MRCP and DWI were analysed.Results: The sensitivity, specificity and accuracy of MRCP according to ERCP results as the gold standard was 97%, 71% and 93% for assessment of biliary dilatation; 100%, 94.7% and 97.5% for the diagnosis of choledocholithiasis; 93.7%, 100% and 99% for the identification of benign strictures; 100%, 100% and 100% for the diagnosis of malignant tumours; and 100%, 100% and 100% for the detection of complicated hydatid cysts; respectively. The sensitivity and specificity of DWI for the diagnosis of malignant tumour was 100%. In the detection of choledocholithiasis, the sensitivity and specificity of DWI was 70.8% and 100%.Conclusions: MRCP is an alternative, non-invasive, diagnostic modality, comparable with ERCP for the evaluation of pancreaticobiliary diseases. DWI can be helpful for diagnosis of choledocholithiasis and tumours.

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Role of Diffusion Weighted Imaging in Differentiating Benign from Pathological Vertebral Compression

QJM ◽

10.1093/qjmed/hcab106.010 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Faten Mohammed Mahmoud Kamel ◽

Hazem Ibrahim Abdel Rahman ◽

Amany Sayed Khaleel Ahmed Elkhayat

Keyword(s):

Vertebral Fractures ◽

Diffusion Weighted Imaging ◽

Laboratory Evaluation ◽

Vertebral Collapse ◽

Adc Value ◽

Conventional Mri ◽

Diffusion Weighted ◽

Significant Difference

Abstract Background Vertebral collapse is a common problem due to benign conditions (trauma, infection, osteoporosis) or malignant process. And although the spine is the most common site of bone metastases (39% of bony metastases in patients with primary neoplasms) benign vertebral fractures due to osteopenia occur in one third of cancer patients, making it essential to determine whether the cause of vertebral collapse is benign or malignant. Aim of the Work To establish the role of DWI in differentiating benign from pathologic vertebral fractures using ADC values in comparison with histopathology report /laboratory evaluation and clinical follow-up. Patients and Methods A cross sectional study is approved by the ethics review board of Ain Shams University Hospital (Al Demerdash). All patients provided informed consent for the MR imaging examinations and for inclusion of their data in this analysis. From April 2020 to october 2020, 25 cases with previous imaging with vertebral compression underwent conventional MRI study on the affected region. Diffusion weighted imaging and ADC was added. Results We performed DWI using maximum b-values 600, and quantitative analysis, named apparent diffusion coefficient (ADC). We correlated the ADC number to histopathology, laboratory finding and clinical follow up. In our study there was significant difference (p < 0.04) between DWI of the benign and malignant groups. Also the ADC value showed significant difference <0.001. The mean ADCs of benign VCFs were higher significantly than those of pathological fractures. Conclusion DWI with ADC value was helpful when added to conventional MRI to differentiate benign from pathological (malignant) vertebral compression. It should be a routine sequence in patients with vertebral compression fractures for accurate diagnosis and successful management also can decrease no of biopsies.

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Incorporating diffusion-weighted imaging in a diagnostic algorithm for multiparametric MR mammography

Acta Radiologica ◽

10.1177/02841851211041822 ◽

2021 ◽

pp. 028418512110418

Author(s):

Katerina Vassiou ◽

Michael Fanariotis ◽

Ioannis Tsougos ◽

Ioannis Fezoulidis

Keyword(s):

Sensitivity And Specificity ◽

Predictive Value ◽

Region Of Interest ◽

Diagnostic Algorithm ◽

Breast Lesions ◽

Adc Value ◽

Diffusion Weighted ◽

Adc Values ◽

Single Formula ◽

Sensitivity Specificity

Background Apparent diffusion coefficient (ADC) measurements are not incorporated in BI-RADS classification. Purpose To assess the probability of malignancy of breast lesions at magnetic resonance mammography (MRM) at 3 T, by combining ADC measurements with the BI-RADS score, in order to improve the specificity of MRM. Material and Methods A total of 296 biopsy-proven breast lesions were included in this prospective study. MRM was performed at 3 T, using a standard protocol with dynamic sequence (DCE-MRI) and an extra echo-planar diffusion-weighted sequence. A freehand region of interest was drawn inside the lesion, and ADC values were calculated. Each lesion was categorized according to the BI-RADS classification. Logistic regression analysis was employed to predict the probability of malignancy of a lesion. The model combined the BI-RADS classification and the ADC value. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were calculated. Results In total, 153 malignant and 143 benign lesions were analyzed; 257 lesions were masses and 39 lesions were non-mass-like enhancements. The sensitivity and specificity of the combined method were 96% and 86%, respectively, in contrast to 95% and 81% with BI-RADS classification alone. Conclusion We propose a method of assessing the probability of malignancy in breast lesions by combining BI-RADS score and ADC values into a single formula, increasing sensitivity and specificity compared to BI-RADS classification alone.

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Accelerated acquisition of carotid MR angiography using 3D gradient-echo imaging with two-point Dixon

Neuroradiology ◽

10.1007/s00234-020-02452-6 ◽

2020 ◽

Vol 62 (10) ◽

pp. 1345-1349

Author(s):

Ryusuke Irie ◽

Shiori Amemiya ◽

Tsuyoshi Ueyama ◽

Yuichi Suzuki ◽

Kouhei Kamiya ◽

...

Keyword(s):

Signal Intensity ◽

Intensity Ratio ◽

Mr Angiography ◽

Carotid Bifurcation ◽

Visual Assessment ◽

Signal Intensity Ratio ◽

Scan Time ◽

Signal Change ◽

Significant Difference ◽

Gradient Echo Imaging

Abstract This pilot study tests the feasibility of rapid carotid MR angiography using the liver acquisition with volume acceleration-flex technique (LAVA MRA). Seven healthy volunteers and 21 consecutive patients suspected of carotid stenosis underwent LAVA and conventional time-of-flight (cTOF) MRAs. Artery-to-fat and artery-to-muscle signal intensity ratios were manually measured. LAVA MRA exhibited a significantly larger artery-to-fat signal intensity ratio compared with cTOF MRA in all slices (P < 0.001) and exhibited a larger (P < 0.001) or equivalent (P = 1.0) artery-to-muscle signal intensity ratio in the extracranial carotid arteries. The image quality of the cervical carotid bifurcation and the signal change on each MRA were visually assessed and compared among the MRAs. There was no significant difference between the two MRAs in visual assessment. LAVA MRA can provide visualization similar to cTOF MRA in the evaluation of the cervical carotid bifurcation while reducing scan time by one-fifth.

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Diffusion-weighted imaging of primary brain lymphomas: Effect of ADC value and signal intensity of T2-weighted imaging

Computerized Medical Imaging and Graphics ◽

10.1016/j.compmedimag.2008.06.001 ◽

2008 ◽

Vol 32 (7) ◽

pp. 539-543 ◽

Cited By ~ 9

Author(s):

Masuma Akter ◽

Toshinori Hirai ◽

Keishi Makino ◽

Mika Kitajima ◽

Ryuji Murakami ◽

...

Keyword(s):

Signal Intensity ◽

Diffusion Weighted Imaging ◽

Adc Value ◽

Diffusion Weighted

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Role of Diffusion-Weighted Imaging in the Evaluation of Perianal Fistulae

Indian Journal of Radiology and Imaging ◽

10.1055/s-0041-1729673 ◽

2021 ◽

Author(s):

Deb K. Boruah ◽

Karuna Hazarika ◽

Halimuddin Ahmed ◽

Krishna K. Borah ◽

Samudra Borah ◽

...

Keyword(s):

Diffusion Weighted Imaging ◽

Imaging Modality ◽

Perianal Fistula ◽

P Value ◽

Adc Value ◽

Perianal Fistulas ◽

Diffusion Weighted ◽

Significant Difference ◽

Perianal Fistulae

Abstract Background Magnetic resonance imaging (MRI) is the imaging modality of choice for evaluating perianal fistulae, due to its ability to show the relationship of perianal fistulae with anal sphincters, fistula extensions, secondary ramifications and associated complications. Aim To evaluate the role of diffusion-weighted MRI in the evaluation of perianal fistulae. Settings and Design A hospital-based cross-sectional study. Materials and Methods The study group composed of 47 patients of perianal fistula. MRI with diffusion-weighted imaging (DWI) was performed with Philips 0.5 T Ingenia scanner. DWI with different b-values (b = 50, b = 400, and b = 800 smm2) were obtained. The MRI findings were correlated with local clinical examination and or surgical findings. Statistical Analysis Used Chi-square test, independent samples t-test, and receiver operating characteristic curve analysis. Result Fifty-nine perianal fistulas in 47 patients were included in the study sample. The visibility of perianal fistula on DWI was less than T2-weighted (T2W) and combined DWI-T2W images. Distinctly visualized (visibility score 2) perianal fistulas were observed in 47 fistulas (79.6%) on DWI, 54 (91.5%) on T2W, and 58 (98.3%) on DWI-T2W images. The mean of apparent diffusion coefficient (ADC) values of active fistula was 0.972 ± 0.127 [SD] 10−3 mm2/s and inactive was 1.232 ± 0.185 [SD] 10−3 mm2/s with a significant difference (p-value < 0.0005). A cut-off mean ADC value of 1.105 × 10−3 mm2/s was used to differentiate active from the inactive fistula with a sensitivity of 87.5% and specificity of 73.3%. Conclusion Combined DWI-T2W evaluation had a better performance in the detection of fistula than DWI or T2W alone. DWI with mean ADC calculation had a good performance in differentiating active from the inactive fistulas.

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