Published ahead of print on November 26, 2007
doi: 10.3174/ajnr.A0849
Role of Apparent Diffusion Coefficient Values in Differentiation Between Malignant and Benign Solitary Thyroid Nodules
A.A.K. Abdel Razeka,
A.G. Sadeka,
O.R. Kombara,
T.E. Elmahdyb and
N. Nadac
a Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt
b Department of Endocrine Surgery, Mansoura Faculty of Medicine, Mansoura, Egypt
c Department of Pathology, Mansoura Faculty of Medicine, Mansoura, Egypt
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Fig 1. Measurement of the ADC value of a thyroid nodule in an ADC map image. The region of interest is drawn around the thyroid nodule, and the ADC value is measured.
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Fig 2. Adenomatous nodule. A–C, Axial T1- and T2-weighted and coronal T1-weighted MR images of the neck, respectively, showing a well-defined oval mainly solid solitary nodule (arrow) affecting the right thyroid lobe with contralateral tracheal displacement. D, An ADC map image with hyperintensity of the nodule (arrow) denoting increased diffusion and a measured ADC value of 1.57 ± 0.11 x 10–3 mm2/s.
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Fig 3. Follicular adenoma. A and B, Axial T1- and T2-weighted MR images, respectively, showing a well-defined more or less oval solitary nodule affecting the right thyroid lobe with contralateral tracheal displacement. The nodule has an anterior cystic part (arrow) and another posterior solid one (arrowhead). C, An ADC map image with marked hyperintensity of the anterior cystic portion of the nodule (arrow), denotes increased diffusion with a measured ADC value of 2.25 ± 0.18 x 10–3 mm2/s and a relatively hypointense posterior solid portion (arrowhead), denotes relatively restricted diffusion with a measured ADC value of 1.2 ± 0.08 x 10–3 mm2/s.
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Fig 4. Thyroid cyst. A–C, Axial T1- and T2-weighted and coronal T1-weighted MR images, respectively, showing a well-defined more or less oval solitary nodule (arrow) affecting the right thyroid lobe. D, An ADC map image with marked hyperintensity of the nodule (arrow) denoting increased diffusion, and the measured ADC value is 2.05 ± 0.13 x 10–3 mm2/s.
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Fig 5. Hemorrhagic thyroid cyst. A and B, Axial T1- and T2-weighted MR images, respectively, showing a small well-defined more or less rounded solitary nodule (arrow) affecting the right thyroid lobe. The nodule is hyperintense on both T1- and T2-weighted images. C, An ADC map image shows low signal intensity of the nodule. The measured ADC value is 0.5 ± 0.07 x 10–3 mm2/s.
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Fig 6. Papillary carcinoma of the thyroid. A and B, Axial T1- and T2-weighted MR images, respectively, showing a well-defined irregular mainly solid solitary nodule (arrow) involving all the right thyroid lobe with contralateral tracheal displacement. C, ADC map image shows hypointensity of the nodule (arrow). The measured ADC value is 0.97 ± 0.1 x 10–3 mm2/s.
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Fig 7. Follicular carcinoma of the thyroid. A and B, Axial T1- and T2-weighted MR images, respectively, showing a well-defined more or less oval mainly solid solitary nodule (arrowheads) affecting the right thyroid lobe with contralateral tracheal displacement. C, ADC map image shows a low ADC value (0.92 ± 0.06 x 10–3 mm2/s) of the thyroid nodule (arrowhead).
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Fig 8. ROC curve of the ADC value used for differentiation of benign from malignant solitary thyroid nodules. The area under the curve measures 97%.
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