@article {Schueller-Weidekamm417, author = {C. Schueller-Weidekamm and K. Kaserer and G. Schueller and C. Scheuba and H. Ringl and M. Weber and C. Czerny and A.M. Herneth}, title = {Can Quantitative Diffusion-Weighted MR Imaging Differentiate Benign and Malignant Cold Thyroid Nodules? Initial Results in 25 Patients}, volume = {30}, number = {2}, pages = {417--422}, year = {2009}, doi = {10.3174/ajnr.A1338}, publisher = {American Journal of Neuroradiology}, abstract = {BACKGROUND AND PURPOSE: The characterization of cold nodules of the thyroid gland is mandatory because approximately 20\% of these nodules are of malignant origin. The purpose of this study was to evaluate the distinction of cold thyroid nodules by using quantitative diffusion-weighted MR imaging (DWI).MATERIALS AND METHODS: In 25 patients with cold nodules on scintigraphy and suggestive findings at fine-needle aspiration, thyroid carcinoma was suggested. In these patients, cold nodules and the normal parenchyma of the contralateral thyroid lobe were prospectively investigated with quantitative DWI (echo-planar imaging sequence; maximum b-value, 800 s/mm2) before surgery. The differences in the mean apparent diffusion coefficient (ADC) values in benign and malignant nodules were tested by using a Mann-Whitney U test.RESULTS: Histologically, there were 20 carcinomas with a minimum size of 8 mm and 5 adenomas. The mean ADC values (in 10-3 mm2/s) differed significantly among carcinoma, adenoma, and normal parenchyma (P \< .05). The ranges (95\% confidence interval) of the ADC values for carcinoma (2.43{\textendash}3.037), adenoma (1.626{\textendash}2.233), and normal parenchyma (1.253{\textendash}1.602) showed no overlap. When an ADC value of 2.25 or higher was used for predicting malignancy, the highest accuracy of 88\%, with 85\% sensitivity and 100\% specificity, was obtained.CONCLUSIONS: Quantitative DWI seems to be a feasible tool with which to differentiate thyroid carcinomas from adenomas; however, further studies are required including larger numbers of patients to confirm our results.}, issn = {0195-6108}, URL = {https://www.ajnr.org/content/30/2/417}, eprint = {https://www.ajnr.org/content/30/2/417.full.pdf}, journal = {American Journal of Neuroradiology} }