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

Huanhuan Ren1, Diwei Shi2,3, Junhao Huang1

  • 1Department of Radiology, Chongqing University Cancer Hospital, Chongqing, China.

Journal of Magnetic Resonance Imaging : JMRI
|August 21, 2025
PubMed
Summary

Time-dependent diffusion MRI (td-dMRI) parameters, including tumor size and cellularity, can help distinguish benign from malignant thyroid nodules. Combining td-dMRI with the TI-RADS classification system significantly improves diagnostic accuracy for papillary thyroid cancer (PTC).

Keywords:
diagnosisdiffusion MRIthyroid

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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.