Translational Oncology (Oct 2016)

Diffusion-Weighted Imaging Using a Readout-Segmented, Multishot EPI Sequence at 3 T Distinguishes between Morphologically Differentiated and Undifferentiated Subtypes of Thyroid Carcinoma—A Preliminary Study

  • Stefan Schob,
  • Peter Voigt,
  • Lionel Bure,
  • Hans-Jonas Meyer,
  • Claudia Wickenhauser,
  • Curd Behrmann,
  • Annekathrin Höhn,
  • Paul Kachel,
  • Henning Dralle,
  • Karl-Titus Hoffmann,
  • Alexey Surov

DOI
https://doi.org/10.1016/j.tranon.2016.09.001
Journal volume & issue
Vol. 9, no. 5
pp. 403 – 410

Abstract

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BACKGROUND: Thyroid carcinomas represent the most frequent endocrine malignancies. Recent studies were able to distinguish malignant from benign nodules of the thyroid gland with diffusion-weighted imaging (DWI). Although this differentiation is undoubtedly helpful, presurgical discrimination between well-differentiated and undifferentiated carcinomas would be crucial to define the optimal treatment algorithm. Therefore, the aim of this study was to investigate if readout-segmented multishot echo planar DWI is able to differentiate between differentiated and undifferentiated subtypes of thyroid carcinomas. PATIENTS AND METHODS: Fourteen patients with different types of thyroid carcinomas who received preoperative DWI were included in our study. In all lesions, apparent diffusion coefficient (ADC)min, ADCmean, ADCmax, and D were estimated on the basis of region of interest measurements after coregistration with T1-weighted, postcontrast images. All tumors were resected and analyzed histopathologically. Ki-67 index, p53 synthesis, cellularity, and total and average nucleic areas were estimated using ImageJ version 1.48. RESULTS: Analysis of variance revealed a statistically significant difference in ADCmean values between differentiated and undifferentiated thyroid carcinomas (P = .022). Spearman Rho calculation identified significant correlations between ADCmax and cell count (r = 0.541, P = .046) as well as between ADCmax and total nuclei area (r = 0.605, P = .022). CONCLUSION: DWI can distinguish between differentiated and undifferentiated thyroid carcinomas.