Li Guomin, Jiang Guihua, Mei Yingjie, Gao Peng, Liu Ruijian, Jiang Min, Zhao Yue, Li Meng, Wu Yunfan, Fu Shishun, Liu Mengchen, Li Liming, Li Wuming, Yan Jianhao
The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
The Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China.
Front Oncol. 2020 Jun 19;10:918. doi: 10.3389/fonc.2020.00918. eCollection 2020.
Amide proton transfer-weighted (ATPw) imaging is a novel MRI technique that has been used to identify benign and malignant tumors. The present study evaluated the role of APTw imaging in differentiating papillary thyroid carcinoma from predominantly solid adenomatous nodule. This study included 24 cases of solitary papillary thyroid carcinoma, and 20 cases of solid adenomatous nodules. Normal thyroid tissues were examined in 12 healthy subjects. The healthy subjects, eight cases of adenomatous nodule with cystic degeneration, and 12 cases of thyroid goiter, were only considered in the descriptive analysis, not included in our statistical analysis. The mean APTw value and the apparent diffusion coefficients (ADCs) of papillary thyroid carcinoma and solid adenomatous nodule were compared via a Mann-Whitney U test and receiver operating characteristic (ROC)-curve analyses. The adenomatous nodule (3.3 ± 1.3%) exhibited significantly higher APTw value ( < 0.05) than that of the papillary thyroid carcinoma (1.8 ± 0.7%). The optimal cut-off value of the mean APTw value in differentiating papillary thyroid carcinoma from adenomatous nodule was 3.15%, with a sensitivity of 60% and a specificity of 100%. The mean ADC of papillary thyroid carcinoma (1.2 ± 0.2 × 10 mm/) was significantly lower than that of adenomatous nodule (2.0 ± 0.4 × 10 mm/s). The optimal cut-off value of the mean ADC was 1.35 × 10 mm/s, with a sensitivity of 100% and a specificity of 75%. Based on the ROC-curve analysis of APT and ADC, the ADC showed a higher area under the curve (AUC) than that of APT (AUC = 0.84, AUC = 0.95). APTw imaging may be as useful as DWI for the differentiation of papillary thyroid carcinoma from predominantly solid adenomatous nodule. Although the sensitivity of ADC was greater than that of APT, APT had greater specificity.
酰胺质子转移加权（ATPw）成像技术是一种新型的磁共振成像（MRI）技术，已用于鉴别良性和恶性肿瘤。本研究评估了ATPw成像在鉴别甲状腺乳头状癌与实性为主的腺瘤性结节中的作用。本研究纳入24例甲状腺乳头状癌及20例实性腺瘤性结节。对12名健康受试者的正常甲状腺组织进行了检查。健康受试者、8例伴有囊性变的腺瘤性结节及12例甲状腺肿仅纳入描述性分析，未纳入统计分析。采用Mann-Whitney U检验及受试者工作特征（ROC）曲线分析比较甲状腺乳头状癌与实性腺瘤性结节的平均ATPw值及表观扩散系数（ADC）。腺瘤性结节（3.3±1.3%）的ATPw值显著高于甲状腺乳头状癌（1.8±0.7%）（<0.05）。鉴别甲状腺乳头状癌与腺瘤性结节的平均ATPw值的最佳截断值为3.15%，灵敏度为60%，特异度为100%。甲状腺乳头状癌的平均ADC值（1.2±0.2×10⁻³mm²/s）显著低于腺瘤性结节（2.0±0.4×10⁻³mm²/s）。平均ADC的最佳截断值为1.35×10⁻³mm²/s，灵敏度为100%，特异度为75%。基于ATP和ADC的ROC曲线分析，ADC曲线下面积（AUC）高于ATP（AUC=0.84，AUC=0.95）。ATPw成像在鉴别甲状腺乳头状癌与实性为主的腺瘤性结节方面可能与扩散加权成像（DWI）同样有效。虽然ADC的灵敏度高于ATP，但ATP具有更高的特异度。
