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Tomography
Volume 5
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10.18383/j.tom.2018.00054
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Article

Quantitative Non-Gaussian Intravoxel Incoherent Motion Diffusion-Weighted Imaging Metrics and Surgical Pathology for Stratifying Tumor Aggressiveness in Papillary Thyroid Carcinomas

by
David Aramburu Núñez
1,
Yonggang Lu
2,
Ramesh Paudyal
1,
Vaios Hatzoglou
4,
Andre L. Moreira
3,
Jung Hun Oh
1,
Hilda E. Stambuk
4,
Yousef Mazaheri
1,
Mithat Gonen
5,
Ronald A. Ghossein
6,
Ashok R. Shaha
7,
R. Michael Tuttle
8 and
Amita Shukla-Dave
1,4,*
1
Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
2
Department of Radiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
3
Department of Pathology, NYU Langone Medical Center, New York, NY 10016, USA
4
Departments of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
5
Departments of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
6
Departments of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
7
Departments of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
8
Departments of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
*
Author to whom correspondence should be addressed.
Tomography 2019, 5(1), 26-35; https://doi.org/10.18383/j.tom.2018.00054
Submission received: 5 December 2018 / Revised: 5 January 2019 / Accepted: 7 February 2019 / Published: 1 March 2019
Versions Notes

Abstract

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.
Keywords: diffusion-weighted imaging; multi b-value; Gaussian and non-Gaussian; papillary thyroid carcinoma; tumor aggressiveness diffusion-weighted imaging; multi b-value; Gaussian and non-Gaussian; papillary thyroid carcinoma; tumor aggressiveness

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MDPI and ACS Style

Núñez, D.A.; Lu, Y.; Paudyal, R.; Hatzoglou, V.; Moreira, A.L.; Oh, J.H.; Stambuk, H.E.; Mazaheri, Y.; Gonen, M.; Ghossein, R.A.; et al. Quantitative Non-Gaussian Intravoxel Incoherent Motion Diffusion-Weighted Imaging Metrics and Surgical Pathology for Stratifying Tumor Aggressiveness in Papillary Thyroid Carcinomas. Tomography 2019, 5, 26-35. https://doi.org/10.18383/j.tom.2018.00054

AMA Style

Núñez DA, Lu Y, Paudyal R, Hatzoglou V, Moreira AL, Oh JH, Stambuk HE, Mazaheri Y, Gonen M, Ghossein RA, et al. Quantitative Non-Gaussian Intravoxel Incoherent Motion Diffusion-Weighted Imaging Metrics and Surgical Pathology for Stratifying Tumor Aggressiveness in Papillary Thyroid Carcinomas. Tomography. 2019; 5(1):26-35. https://doi.org/10.18383/j.tom.2018.00054

Chicago/Turabian Style

Núñez, David Aramburu, Yonggang Lu, Ramesh Paudyal, Vaios Hatzoglou, Andre L. Moreira, Jung Hun Oh, Hilda E. Stambuk, Yousef Mazaheri, Mithat Gonen, Ronald A. Ghossein, and et al. 2019. "Quantitative Non-Gaussian Intravoxel Incoherent Motion Diffusion-Weighted Imaging Metrics and Surgical Pathology for Stratifying Tumor Aggressiveness in Papillary Thyroid Carcinomas" Tomography 5, no. 1: 26-35. https://doi.org/10.18383/j.tom.2018.00054

APA Style

Núñez, D. A., Lu, Y., Paudyal, R., Hatzoglou, V., Moreira, A. L., Oh, J. H., Stambuk, H. E., Mazaheri, Y., Gonen, M., Ghossein, R. A., Shaha, A. R., Tuttle, R. M., & Shukla-Dave, A. (2019). Quantitative Non-Gaussian Intravoxel Incoherent Motion Diffusion-Weighted Imaging Metrics and Surgical Pathology for Stratifying Tumor Aggressiveness in Papillary Thyroid Carcinomas. Tomography, 5(1), 26-35. https://doi.org/10.18383/j.tom.2018.00054

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