Intravoxel incoherent motion (IVIM) parameters derived from iZOOM diffusion-weighted imaging (DWI) can be used to quantitatively identify malignant thyroid nodules. However, the criteria are not standardized.
Purpose
To determine IVIM parameter values derived from iZOOM DWI that can differentiate malignant from benign thyroid nodules.
Material and Methods
Forty-two patients with 46 pathologically confirmed thyroid nodules. All patients underwent preoperative examinations with conventional and iZOOM DWI. A three-dimensional region of interest was drawn on multiple slices to cover the entire nodule. IVIM parameters (D, pure diffusion; f, perfusion fraction; and D*, pseudodiffusion) were measured. The IVIM parameters of the malignant and benign thyroid nodules were compared using independent samples t-tests, a multiple logistic regression, and receiver operating characteristic (ROC) curve analysis.
Results
D, D*, and f exhibited good reproducibility. The D and f values in the malignant nodules (D = [0.72 ± 0.14] × 10−3 mm2/s, [29.94 ± 7.36] %) were significantly lower than those in benign nodules (D = [1.23 ± 0.35] × 10−3 mm2/s, [36.00 ± 8.35] %). The D value achieved the highest area under curve (0.939). The optimal cut-off value for D was 0.87 × 10−3 mm2/s (sensitivity = 95.83%, specificity = 90.91%, positive predictive value [PPV] = 92.00%, negative predictive value [NPV] = 95.24%, and accuracy rate = 93.48%). The area under ROC curve (AUC) of D combined with the f value did not significantly differ from that of D.
Conclusion
IVIM parameter D derived from iZOOM DWI may be helpful in differentiating malignant from benign thyroid nodules.
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