Preoperative Localization of Parathyroid Adenomas with Diffusion MR Imaging: Readout-segmented versus Single-shot Echo-planar Imaging

Magn Reson Med Sci. 2023 Jan 1;22(1):79-85. doi: 10.2463/mrms.mp.2021-0149. Epub 2022 Mar 4.

Abstract

Purpose: To evaluate whether readout-segmented echo-planar imaging (RS-EPI) diffusion-weighted imaging (DWI) can reduce image distortion and improve the lesion identification in parathyroid adenomas (PTAs) compared to single-shot EPI (SS-EPI) DWI, and to determine whether PTAs can be differentiated from other soft tissue structures of the head and neck region by using the apparent diffusion coefficient (ADC) value.

Methods: We retrospectively analyzed the preoperative MR images including DWI of 24 patients with surgically confirmed PTA. RS-EPI and SS-EPI DWI were evaluated by two independent readers for the identification of the lesions and distortion. The ADC values of the PTAs were compared with those of thyroid glands and cervical lymph nodes.

Results: RS-EPI provided significantly less distortion compared to SS-EPI. RS-EPI tended to have better lesion identification compared with SS-EPI without a statistically significant difference. On SS-EPI, the PTAs had significantly higher ADC values compared with the cervical lymph nodes. On RS-EPI, the PTAs had significantly higher ADC values compared with the thyroid glands and cervical lymph nodes.

Conclusion: RS-EPI reduces the DWI distortion in PTAs. The ADC value obtained using RS-EPI enables the differentiation of PTAs from nearby structures, such as thyroid glands and cervical lymph nodes.

Keywords: apparent diffusion coefficient; diffusion-weighted magnetic resonance imaging; parathyroid adenoma; readout-segmented echo-planar imaging.

MeSH terms

  • Diffusion
  • Diffusion Magnetic Resonance Imaging / methods
  • Echo-Planar Imaging / methods
  • Humans
  • Parathyroid Neoplasms* / diagnostic imaging
  • Parathyroid Neoplasms* / surgery
  • Retrospective Studies

Grants and funding

This study was funded in part by Grants-in-aid for Scientific Research from the Japan Society for the Promotion of Science.