Multi-institutional validation of a novel textural analysis tool for preoperative stratification of suspected thyroid tumors on diffusion-weighted MRI. Magn Reson Med 2016 Apr;75(4):1708-16
Date
05/23/2015Pubmed ID
25995019Pubmed Central ID
PMC4654719DOI
10.1002/mrm.25743Scopus ID
2-s2.0-84930014016 (requires institutional sign-in at Scopus site) 44 CitationsAbstract
PURPOSE: Ultrasound-guided fine needle aspirate cytology fails to diagnose many malignant thyroid nodules; consequently, patients may undergo diagnostic lobectomy. This study assessed whether textural analysis (TA) could noninvasively stratify thyroid nodules accurately using diffusion-weighted MRI (DW-MRI).
METHODS: This multi-institutional study examined 3T DW-MRI images obtained with spin echo echo planar imaging sequences. The training data set included 26 patients from Cambridge, United Kingdom, and the test data set included 18 thyroid cancer patients from Memorial Sloan Kettering Cancer Center (New York, New York, USA). Apparent diffusion coefficients (ADCs) were compared over regions of interest (ROIs) defined on thyroid nodules. TA, linear discriminant analysis (LDA), and feature reduction were performed using the 21 MaZda-generated texture parameters that best distinguished benign and malignant ROIs.
RESULTS: Training data set mean ADC values were significantly different for benign and malignant nodules (P = 0.02) with a sensitivity and specificity of 70% and 63%, respectively, and a receiver operator characteristic (ROC) area under the curve (AUC) of 0.73. The LDA model of the top 21 textural features correctly classified 89/94 DW-MRI ROIs with 92% sensitivity, 96% specificity, and an AUC of 0.97. This algorithm correctly classified 16/18 (89%) patients in the independently obtained test set of thyroid DW-MRI scans.
CONCLUSION: TA classifies thyroid nodules with high sensitivity and specificity on multi-institutional DW-MRI data sets. This method requires further validation in a larger prospective study. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance.
Author List
Brown AM, Nagala S, McLean MA, Lu Y, Scoffings D, Apte A, Gonen M, Stambuk HE, Shaha AR, Tuttle RM, Deasy JO, Priest AN, Jani P, Shukla-Dave A, Griffiths JAuthor
Yonggang Lu PhD Assistant Professor in the Radiology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Area Under Curve
Cohort Studies
Diffusion Magnetic Resonance Imaging
Female
Humans
Image Interpretation, Computer-Assisted
Male
Middle Aged
Reproducibility of Results
Thyroid Gland
Thyroid Neoplasms
