Quantitative Non-Gaussian Intravoxel Incoherent Motion Diffusion-Weighted Imaging Metrics and Surgical Pathology for Stratifying Tumor Aggressiveness in Papillary Thyroid Carcinomas
| Autor: | Ronald Ghossein, Yousef Mazaheri, Yonggang Lu, Mithat Gonen, Ramesh Paudyal, Hilda E. Stambuk, David Aramburu Nunez, Ashok R. Shaha, Andre L. Moreira, R. Michael Tuttle, Amita Shukla-Dave, Jung Hun Oh, Vaios Hatzoglou |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty tumor aggressiveness diffusion-weighted imaging Sensitivity and Specificity multi b-value Gaussian and non-Gaussian papillary thyroid carcinoma 030218 nuclear medicine & medical imaging Papillary thyroid cancer Surgical pathology 03 medical and health sciences 0302 clinical medicine Image Interpretation Computer-Assisted medicine Effective diffusion coefficient Humans Radiology Nuclear Medicine and imaging Prospective Studies Thyroid Neoplasms Watchful Waiting Intravoxel incoherent motion Research Articles Aged Ultrasonography medicine.diagnostic_test Receiver operating characteristic business.industry Magnetic resonance imaging Middle Aged medicine.disease 3. Good health Diffusion Magnetic Resonance Imaging ROC Curve Thyroid Cancer Papillary Histopathology Female Nuclear medicine business 030217 neurology & neurosurgery Diffusion MRI |
| Zdroj: | Tomography Tomography; Volume 5; Issue 1; Pages: 26-35 Volume 5 Issue 1 Pages 26-35 |
| ISSN: | 2379-139X |
| Popis: | We assessed a priori aggressive features using quantitative diffusion-weighted imaging metrics to preclude an active surveillance management approach in patients with papillary thyroid cancer (PTC) with tumor size 1–2 cm. This prospective study enrolled 24 patients with PTC who underwent pretreatment multi-b-value diffusion-weighted imaging on a GE 3 T magnetic resonance imaging scanner. The apparent diffusion coefficient (ADC) metric was calculated from monoexponential model, and the perfusion fraction (f), diffusion coefficient (D), pseudo-diffusion coefficient (D*), and diffusion kurtosis coefficient (K) metrics were estimated using the non-Gaussian intravoxel incoherent motion model. Neck ultrasonography examination data were used to calculate tumor size. The receiver operating characteristic curve assessed the discriminative specificity, sensitivity, and accuracy between PTCs with and without features of tumor aggressiveness. Multivariate logistic regression analysis was performed on metrics using a leave-1-out cross-validation method. Tumor aggressiveness was defined by surgical histopathology. Tumors with aggressive features had significantly lower ADC and D values than tumors without tumor-aggressive features (P < 05). The absolute relative change was 46% in K metric value between the 2 tumor types. In total, 14 patients were in the critical size range (1–2 cm) measured by ultrasonography, and the ADC and D were significantly different and able to differentiate between the 2 tumor types (P < 05). ADC and D can distinguish tumors with aggressive histological features to preclude an active surveillance management approach in patients with PTC with tumors measuring 1–2 cm. |
| Databáze: | OpenAIRE |
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