ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Thyroid Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1672396
This article is part of the Research TopicThyroid eye diseasesView all 9 articles
Intravoxel Incoherent Motion Diffusion-Weighted Imaging in Active Staging of Thyroid-Associated Ophthalmopathy: A Retrospective Study
Provisionally accepted
- 1Department of Radiology, Fuyong People’s Hospital of Baoan District, Shenzhen, China
- 2Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- 3Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Introduction: Intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) can distinguish pure molecular diffusion from microcirculation and blood perfusion; however, its application to the thyroid-associated ophthalmopathy (TAO) orbits remains poorly investigated. In this study, we aimed to assess TAO activity using histograms of turbo spin echo-based IVIM-DWI parameters. Methods: In this retrospective study, we examined 94 patients with TAO (clinical activity score: ≥ 3, active n = 27; < 3, inactive n = 67). IVIM-DWI-derived diffusion coefficient (D), pseudo-diffusion coefficient, perfusion percentage, and apparent diffusion coefficient (ADC) histogram parameters were measured for the internal, inferior, external, and superior rectus muscles in both eyes. Further, the diagnostic efficacy of each parameter and changes in D pre- and post-treatment were determined. Results: Patients with active TAO had mostly higher parameters in the D histograms than those with inactive TAO. The 1st, 5th, 10th, 25th, 50th, and 75th percentiles and the minimum and mean in the D histograms correlated with parameters corresponding to the ADC. The maximum value of the 75th percentile in the D histogram had areas under the curve of 0.892, corresponding to a critical value of > 1.26 μm2/s, which was significantly better than the diagnostic efficacy of sex, age, and smoking. However, the maximum, mean, standard deviation, variance, and 5th, 10th, 75th, 90th, 95th, and 99th percentiles of the D histograms were reduced post-treatment. Conclusion: D histograms facilitate the clinical quantification of extraocular muscle edema and assessment of TAO activity and efficacy. TAO was more likely to be active when the maximum value at the 75th percentile was > 1.26 μm2/s. The study findings indicate the importance of considering adjustment of treatment strategy when these metrics do not diminish significantly post-treatment.
Keywords: Diffusion-weighted imaging, Extraocular muscle, Intravoxel incoherent motion, Thyroid-associated ophthalmopathy, turbo spin echo
Received: 24 Jul 2025; Accepted: 10 Sep 2025.
Copyright: © 2025 Li, Zhang, Wang and Zhu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Tingting Zhu, Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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