Differentiating Benign Thyroid Nodules and Papillary Thyroid Carcinoma Using Time-Dependent Diffusion MRI: A...

Area of Science:

• Radiology and Medical Imaging
• Oncology
• Biophysics

Background:

• Accurate differentiation of benign and malignant thyroid nodules is crucial for effective treatment planning and prognosis.
• Current diagnostic methods lack an ideal approach for distinguishing between benign and malignant thyroid nodules.

Purpose of the Study:

• To evaluate the efficacy of microstructural parameters derived from time-dependent diffusion MRI (td-dMRI) in accurately differentiating benign from malignant thyroid nodules.
• To compare the diagnostic performance of td-dMRI parameters with existing classification systems.

Main Methods:

• A prospective, single-center study involving 232 participants with pathologically diagnosed thyroid nodules.
• Utilized 3.0 T td-dMRI with oscillating and pulsed gradient spin-echo sequences.
• Analyzed clinical factors and td-dMRI parameters (e.g., cellularity, tumor size) using regression models; developed and compared TI-RADS, combined, and integrated models.

Main Results:

• Tumor size and cellularity derived from td-dMRI were independently associated with malignant thyroid nodules.
• A combined model integrating tumor maximum diameter, cellularity, and TI-RADS demonstrated significantly improved diagnostic accuracy (AUC: 0.941) compared to TI-RADS alone (AUC: 0.891).
• The integrated model showed substantial improvements in integrated discrimination improvement (IDI) and net reclassification improvement (NRI).

Conclusions:

• The integrated model combining tumor maximum diameter and cellularity from td-dMRI with TI-RADS shows significant potential for differentiating benign thyroid nodules from papillary thyroid cancer (PTC).
• This approach offers enhanced diagnostic accuracy, aiding in more precise patient management.