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Int. J. Mol. Sci. 2017, 18(4), 821; doi:10.3390/ijms18040821

Histogram Analysis of Diffusion Weighted Imaging at 3T is Useful for Prediction of Lymphatic Metastatic Spread, Proliferative Activity, and Cellularity in Thyroid Cancer

1
Department for Neuroradiology, University Hospital Leipzig, Leipzig 04103, Germany
2
Department for Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig 04103, Germany
3
Department for Ophthalmology, University Hospital Leipzig, Leipzig 04103, Germany
4
Department for Diagnostic and Interventional Neuroradiology, Katharinenhospital Stuttgart, Stuttgart 70174, Germany
5
Institute for Pathology, University Hospital Halle-Wittenberg, Martin-Luther-University Halle-Wittenberg, Halle 06112, Germany
6
Institute for Pathology, University Hospital Leipzig, Leipzig 04103, Germany
*
Author to whom correspondence should be addressed.
Academic Editor: Daniela Gabriele Grimm
Received: 9 March 2017 / Revised: 9 April 2017 / Accepted: 10 April 2017 / Published: 12 April 2017
(This article belongs to the Special Issue Current Knowledge in Thyroid Cancer—From Bench to Bedside)
View Full-Text   |   Download PDF [5781 KB, uploaded 13 April 2017]   |  

Abstract

Pre-surgical diffusion weighted imaging (DWI) is increasingly important in the context of thyroid cancer for identification of the optimal treatment strategy. It has exemplarily been shown that DWI at 3T can distinguish undifferentiated from well-differentiated thyroid carcinoma, which has decisive implications for the magnitude of surgery. This study used DWI histogram analysis of whole tumor apparent diffusion coefficient (ADC) maps. The primary aim was to discriminate thyroid carcinomas which had already gained the capacity to metastasize lymphatically from those not yet being able to spread via the lymphatic system. The secondary aim was to reflect prognostically important tumor-biological features like cellularity and proliferative activity with ADC histogram analysis. Fifteen patients with follicular-cell derived thyroid cancer were enrolled. Lymph node status, extent of infiltration of surrounding tissue, and Ki-67 and p53 expression were assessed in these patients. DWI was obtained in a 3T system using b values of 0, 400, and 800 s/mm2. Whole tumor ADC volumes were analyzed using a histogram-based approach. Several ADC parameters showed significant correlations with immunohistopathological parameters. Most importantly, ADC histogram skewness and ADC histogram kurtosis were able to differentiate between nodal negative and nodal positive thyroid carcinoma. Conclusions: histogram analysis of whole ADC tumor volumes has the potential to provide valuable information on tumor biology in thyroid carcinoma. However, further studies are warranted. View Full-Text
Keywords: thyroid carcinoma; diffusion weighted imaging; lymphatic metastatic spread; ADC histogram analysis; histopathologic features; Ki-67; p53 thyroid carcinoma; diffusion weighted imaging; lymphatic metastatic spread; ADC histogram analysis; histopathologic features; Ki-67; p53
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Schob, S.; Meyer, H.J.; Dieckow, J.; Pervinder, B.; Pazaitis, N.; Höhn, A.K.; Garnov, N.; Horvath-Rizea, D.; Hoffmann, K.-T.; Surov, A. Histogram Analysis of Diffusion Weighted Imaging at 3T is Useful for Prediction of Lymphatic Metastatic Spread, Proliferative Activity, and Cellularity in Thyroid Cancer. Int. J. Mol. Sci. 2017, 18, 821.

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