Prospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 26, 2022; 10(24): 8587-8598
Published online Aug 26, 2022. doi: 10.12998/wjcc.v10.i24.8587
Quantitative differentiation of malignant and benign thyroid nodules with multi-parameter diffusion-weighted imaging
Xiang Zhu, Jia Wang, Yan-Chun Wang, Ze-Feng Zhu, Jian Tang, Xiao-Wei Wen, Ying Fang, Jun Han
Xiang Zhu, Jia Wang, Yan-Chun Wang, Ze-Feng Zhu, Jun Han, Department of Radiology, The First Hospital of Jiaxing & The Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
Jian Tang, Department of Head and Neck Surgery, the First Hospital of Jiaxing & The Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
Xiao-Wei Wen, Ying Fang, Department of Pathology, The First Hospital of Jiaxing & The Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
Author contributions: Zhu X and Han J designed the research study; Wang J and Wang YC performed the research; Zhu ZF and Tang J contributed software and formal analysis; Wen XW and Fang Y analyzed the data; Zhu X and Han J wrote the manuscript; all authors have read and approve the final manuscript.
Supported by the Health Commission of Zhejiang Province, No. 2019KY690.
Institutional review board statement: The study was reviewed and approved by the First Hospital of Jiaxing Research and Ethics Committee [(Approval No.2017-226)].
Clinical trial registration statement: The clinical trial is registered with Chinese Clinical Trial Registry, using identifier ChiCTR2200061944. Details can be found at http://www.chictr.org.cn/index.aspx.
Informed consent statement: All study participants, or their legal guardian, provided written consent prior to study enrollment.
Conflict-of-interest statement: All the authors declare no conflict of interest.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT Statement—checklist of items, and the manuscript was prepared and revised according to the CONSORT Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun Han, MD, Associate Chief Physician, Department of Radiology, The First Hospital of Jiaxing & The Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing 314000, Zhejiang Province, China. 13706735435@163.com
Received: September 10, 2021
Peer-review started: September 10, 2021
First decision: January 18, 2022
Revised: January 25, 2022
Accepted: July 19, 2022
Article in press: July 19, 2022
Published online: August 26, 2022
ARTICLE HIGHLIGHTS
Research background

The value of multiparameter diffusion-weighted imaging (DWI) in quantitative evaluation of thyroid nodule has not been clarified.

Research motivation

It provides a new idea for differentiating benign and malignant thyroid results by using multiparametric diffusion-weighted imaging.

Research objectives

To provide a non-invasive diagnostic means for differentiating benign and malignant thyroid nodules by multiparametric DWI, furthermore, we elucidated which parameters have diagnostic function in differentiating the nature of thyroid nodule

Research methods

We obtained Multiple DWI parameters by patients who underwent multi-b value diffusion-weighted imaging of the thyroid,then the data of benign and malignant nodules were obtained and analyzed.

Research results

Malignant lesions displayed lower diffusion parameters including apparent diffusion coefficient (ADC), the true diffusion coefficient (D), the perfusion fraction (f), the distributed diffusion coefficient (DDC), the intravoxel water diffusion heterogeneity (α) and kurtosis model-derived ADC (Dapp), and higher apparent diffusional kurtosis (Kapp) than benign entities (all P < 0.01). The area under the ROC curve (AUC) of the ADC(0 and 1000) was significantly higher than the AUC of D*, f and α (all P < 0.05) for differentiating benign from malignant lesions.

Research conclusions

The metrics including D, DDC, Dapp and Kapp provide additional information with similar diagnostic performance of ADC, combination of these metrics may contribute to differentiate benign and malignant thyroid nodules.

Research perspectives

In the future, multiple parameters of magnetic resonance diffusion can be used to accurately distinguish benign and malignant thyroid nodules.