Abstract
Background: Amide proton transfer-weighted (ATPw) imaging is a novel MRI technique that has been used to identify benign and malignant tumors. The present study evaluated the role of APTw imaging in differentiating papillary thyroid carcinoma from predominantly solid adenomatous nodule.Methods: This study included 24 cases of solitary papillary thyroid carcinoma, and 20 cases of solid adenomatous nodules. Normal thyroid tissues were examined in 12 healthy subjects. The healthy subjects, eight cases of adenomatous nodule with cystic degeneration, and 12 cases of thyroid goiter, were only considered in the descriptive analysis, not included in our statistical analysis. The mean APTw value and the apparent diffusion coefficients (ADCs) of papillary thyroid carcinoma and solid adenomatous nodule were compared via a Mann-Whitney U test and receiver operating characteristic (ROC)-curve analyses.Results: The adenomatous nodule (3.3 ± 1.3%) exhibited significantly higher APTw value (p < 0.05) than that of the papillary thyroid carcinoma (1.8 ± 0.7%). The optimal cut-off value of the mean APTw value in differentiating papillary thyroid carcinoma from adenomatous nodule was 3.15%, with a sensitivity of 60% and a specificity of 100%. The mean ADC of papillary thyroid carcinoma (1.2 ± 0.2 × 10−3 mm2/s) was significantly lower than that of adenomatous nodule (2.0 ± 0.4 × 10−3 mm2/s). The optimal cut-off value of the mean ADC was 1.35 × 10−3 mm2/s, with a sensitivity of 100% and a specificity of 75%. Based on the ROC-curve analysis of APT and ADC, the ADC showed a higher area under the curve (AUC) than that of APT (AUCAPT = 0.84, AUCADC = 0.95).Conclusion: APTw imaging may be as useful as DWI for the differentiation of papillary thyroid carcinoma from predominantly solid adenomatous nodule. Although the sensitivity of ADC was greater than that of APT, APT had greater specificity.
Highlights
The precise preoperative differentiation of nodular goiter or adenoma and papillary thyroid carcinoma is of significant practical relevance
We first assessed the radiographic features of some interesting cases and normal thyroids using several standards sequences (T1-weight images, T2-weight images, Gd- T1-weight images, diffusion-weighted imaging (DWI)) and
We explored the diagnostic performance of using APTw imaging to differentiate papillary thyroid carcinoma from the solid adenomatous nodule
Summary
Nodular goiters and adenomas are the most common benign thyroid nodules, and papillary thyroid carcinoma is the most common malignant thyroid tumors [1]. The precise preoperative differentiation of nodular goiter or adenoma and papillary thyroid carcinoma is of significant practical relevance. Adenomas can occur alone or in combination with nodular goiters Their morphologies, signals, and enhancements are similar, often resulting in difficult differential diagnoses. Solitary solid nodular goiters are challenging to identify with adenomas. We used adenomatous nodules [2,3,4] to replace solitary solid nodular goiters or thyroid adenomas in the present study. The present study evaluated the role of APTw imaging in differentiating papillary thyroid carcinoma from predominantly solid adenomatous nodule
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