Work

Impact of Diffusion‐Weighted Magnetic Resonance Imaging Parameters on Diagnostic Accuracy for Thyroid Nodules: A Systematic Review and Meta‐Analysis

Year: 2025

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: BACKGROUND: Surgery is the gold standard to differentiate benign from malignant thyroid nodules, but it is invasive and often unnecessary in indeterminate cases. Diffusion-Weighted MRI (DW-MRI) has emerged as a promising, non-invasive tool, though its accuracy and the impact of acquisition parameters remain unclear. PURPOSE: To evaluate the diagnostic accuracy of DW-MRI in distinguishing malignant from benign thyroid nodules and identifying influencing acquisition parameters. STUDY TYPE: Systematic Review and Meta-analysis (researchregistry11482). POPULATION: 2073 patients, 2403 thyroid nodules (1067 malignant). FIELD STRENGTH/SEQUENCE: DW-MRI at 3.0T or 1.5T. ASSESSMENT: A systematic search of Pubmed, Embase, Cochrane Library, Scopus, and Web of Science was conducted through July 2025 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses of Diagnostic Test Accuracy guidelines. Studies on DW-MRI in thyroid nodules were included. Risk of bias and applicability were assessed using QUADAS-2. STATISTICAL TESTS: A bivariate random-effects model estimated pooled sensitivity (SE), specificity (SP), and area under the curve (AUC). Univariable and multivariable meta-regressions explored the influence of DW-MRI parameters. Subgroup analyses and pooled Apparent Diffusion Coefficient (ADC) comparisons were also performed. Results were considered statistically significant at p < 0.05. RESULTS: /s for benign), especially with b ≥ 1000. DATA CONCLUSION: DW-MRI shows good diagnostic accuracy for thyroid nodule assessment, although it is influenced by both technical and methodological factors. TECHNICAL EFFICACY: Stage 3.

Source: Journal of Magnetic Resonance Imaging

DOI: 10.1002/jmri.70141