Evidence map›Paper›PMID 41098067›Full record

SynthesisJournal of magnetic resonance imaging : JMRI2026

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

Caterina Giannitto, Angela Ammirabile, Giorgia Carnicelli, Ludovica Lofino, Andrea Costantino, Fabrizio Natali, Andrea Alessandro Esposito, Armando De Virgilio, Antonio Lo Casto, Giovanni Savini and 4 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Journal of magnetic resonance imaging : JMRI, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Caterina GiannittoDepartment of Diagnostic and Interventional Radiology, IRCCS Humanitas Research Hospital, Milan, Italy.ORCID https://orcid.org/0000-0001-7894-9441
Angela AmmirabileDepartment of Diagnostic and Interventional Radiology, IRCCS Humanitas Research Hospital, Milan, Italy.
Giorgia CarnicelliDepartment of Diagnostic and Interventional Radiology, IRCCS Humanitas Research Hospital, Milan, Italy.
Ludovica LofinoDepartment of Diagnostic and Interventional Radiology, IRCCS Humanitas Research Hospital, Milan, Italy.
Andrea CostantinoDepartment of Biomedical Sciences, Humanitas University, Milan, Italy.
Fabrizio NataliSchool of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
Andrea Alessandro EspositoDepartment of Diagnostic Radiology, ASST, Bergamo, Italy.
Armando De VirgilioDepartment of Biomedical Sciences, Humanitas University, Milan, Italy.
Antonio Lo CastoSezione di Scienze Radiologiche, DIBIMEF, Università Degli Studi di Palermo, Palermo, Italy.
Giovanni SaviniDepartment of Diagnostic and Interventional Radiology, IRCCS Humanitas Research Hospital, Milan, Italy.
Lorenzo UggaDepartment of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.
Giuseppe MercanteDepartment of Biomedical Sciences, Humanitas University, Milan, Italy.
Letterio Salvatore PolitiDepartment of Diagnostic and Interventional Radiology, IRCCS Humanitas Research Hospital, Milan, Italy.ORCID https://orcid.org/0000-0002-6190-6688
Steve ConnorDepartment of Neuroradiology, King's College Hospital, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSurgery 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.

resultsThirty-seven studies were included. DW-MRI 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-regression revealed that 3.0T field strength reduced SP, while < 5 averages and acquisition matrix ≥ 130 increased SE. Nodule size ≥ 10 mm and circular region of interest improved SP. Multivariable analysis confirmed increased SE with b-values > 2 and improved SP with b ≥ 1000, while 3.0 T remained associated with reduced SP. Malignant nodules showed lower ADC (1.08 vs. 1.73 × 10 DATA

conclusionDW-MRI shows good diagnostic accuracy for thyroid nodule assessment, although it is influenced by both technical and methodological factors. LEVEL OF EVIDENCE: 3: TECHNICAL EFFICACY: Stage 3.

Indexed as

Diffusion Magnetic Resonance ImagingThyroid NoduleAdultDiagnosis, DifferentialFemaleHumansMaleMiddle AgedReproducibility of ResultsSensitivity and SpecificityThyroid Glanddata accuracydiffusion‐weighted MRImeta‐analysisthyroid nodule

Identifiers

PMID41098067
PMCPMC12891761

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.