{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T13:31:48Z","timestamp":1770816708995,"version":"3.50.1"},"reference-count":58,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2026,3]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Surgery is the gold standard to differentiate benign from malignant thyroid nodules, but it is invasive and often unnecessary in indeterminate cases. Diffusion\u2010Weighted MRI (DW\u2010MRI) has emerged as a promising, non\u2010invasive tool, though its accuracy and the impact of acquisition parameters remain unclear.<\/jats:p>\n <\/jats:sec>\n \n Purpose<\/jats:title>\n To evaluate the diagnostic accuracy of DW\u2010MRI in distinguishing malignant from benign thyroid nodules and identifying influencing acquisition parameters.<\/jats:p>\n <\/jats:sec>\n \n Study Type<\/jats:title>\n Systematic Review and Meta\u2010analysis (researchregistry11482).<\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n 2073 patients, 2403 thyroid nodules (1067 malignant).<\/jats:p>\n <\/jats:sec>\n \n Field Strength\/Sequence<\/jats:title>\n DW\u2010MRI at 3.0T or 1.5T.<\/jats:p>\n <\/jats:sec>\n \n Assessment<\/jats:title>\n 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\u2010Analyses of Diagnostic Test Accuracy guidelines. Studies on DW\u2010MRI in thyroid nodules were included. Risk of bias and applicability were assessed using QUADAS\u20102.<\/jats:p>\n <\/jats:sec>\n \n Statistical Tests<\/jats:title>\n \n A bivariate random\u2010effects model estimated pooled sensitivity (SE), specificity (SP), and area under the curve (AUC). Univariable and multivariable meta\u2010regressions explored the influence of DW\u2010MRI parameters. Subgroup analyses and pooled Apparent Diffusion Coefficient (ADC) comparisons were also performed. Results were considered statistically significant at\n p<\/jats:italic>\n \u2009<\u20090.05.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Thirty\u2010seven studies were included. DW\u2010MRI showed pooled SE 0.84, SP 0.87, and AUC 0.91, confirmed in studies at low risk of bias (AUC 0.80). Univariable meta\u2010regression revealed that 3.0T field strength reduced SP, while <\u20095 averages and acquisition matrix \u2265\u2009130 increased SE. Nodule size \u2265\u200910\u2009mm and circular region of interest improved SP. Multivariable analysis confirmed increased SE with\n b<\/jats:italic>\n \u2010values >\u20092 and improved SP with\n b<\/jats:italic>\n \u2009\u2265\u20091000, while 3.0\u2009T remained associated with reduced SP. Malignant nodules showed lower ADC (1.08 vs. 1.73\u2009\u00d7\u200910\n \u22123<\/jats:sup>\n \u2009mm\n 2<\/jats:sup>\n \/s vs. 1.70\u2009\u00d7\u200910\n \u22123<\/jats:sup>\n \u2009mm\n 2<\/jats:sup>\n \/s for benign), especially with\n b<\/jats:italic>\n \u2009\u2265\u20091000.\n <\/jats:p>\n <\/jats:sec>\n \n Data Conclusion<\/jats:title>\n DW\u2010MRI shows good diagnostic accuracy for thyroid nodule assessment, although it is influenced by both technical and methodological factors.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n 3.<\/jats:p>\n <\/jats:sec>\n \n Technical Efficacy<\/jats:title>\n Stage 3.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jmri.70141","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T07:51:37Z","timestamp":1760601097000},"page":"733-747","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Diffusion\u2010Weighted Magnetic Resonance Imaging Parameters on Diagnostic Accuracy for Thyroid Nodules: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7894-9441","authenticated-orcid":false,"given":"Caterina","family":"Giannitto","sequence":"first","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology IRCCS Humanitas Research Hospital Milan Italy"},{"name":"Department of Biomedical Sciences Humanitas University Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Ammirabile","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology IRCCS Humanitas Research Hospital Milan Italy"},{"name":"Department of Biomedical Sciences Humanitas University Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgia","family":"Carnicelli","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology IRCCS Humanitas Research Hospital Milan Italy"},{"name":"Department of Biomedical Sciences Humanitas University Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ludovica","family":"Lofino","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology IRCCS Humanitas Research Hospital Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Costantino","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences Humanitas University Milan Italy"},{"name":"Otorhinolaryngology Unit IRCCS Humanitas Research Hospital Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrizio","family":"Natali","sequence":"additional","affiliation":[{"name":"School of Medicine and Surgery University of Milano\u2010Bicocca Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea Alessandro","family":"Esposito","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, ASST Bergamo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armando","family":"De Virgilio","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences Humanitas University Milan Italy"},{"name":"Otorhinolaryngology Unit IRCCS Humanitas Research Hospital Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio Lo","family":"Casto","sequence":"additional","affiliation":[{"name":"Sezione di Scienze Radiologiche, DIBIMEF, Universit\u00e0 Degli Studi di Palermo Palermo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Savini","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology IRCCS Humanitas Research Hospital Milan Italy"},{"name":"Department of Biomedical Sciences Humanitas University Milan 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