Characterization of parotid gland tumors: added value of permeability MR imaging to DWI and DCE-MRI

Objectives To determine added value of permeability MRI in parotid tumor characterization to T2-weighted imaging (T2WI), semi-quantitative analysis of time-intensity curve (TIC), and intra-voxel incoherent motion diffusion-weighted imaging (IVIM-DWI). Methods This retrospective study was approved by...

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Bibliographic Details
Published in:European radiology 2020-12, Vol.30 (12), p.6402-6412
Main Authors: Yabuuchi, Hidetake, Kamitani, Takeshi, Sagiyama, Koji, Yamasaki, Yuzo, Hida, Tomoyuki, Matsuura, Yuko, Hino, Takuya, Murayama, Yuriko, Yasumatsu, Ryuji, Yamamoto, Hidetaka
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Biopsy
Contrast Media
Diagnosis, Differential
Diagnostic Radiology
Diagnostic systems
Diffusion
Diffusion Magnetic Resonance Imaging - methods
Exocrine glands
Female
Head and Neck
Humans
Image Enhancement - methods
Imaging
Informed consent
Internal Medicine
Interventional Radiology
Magnetic resonance imaging
Magnetic Resonance Imaging - methods
Male
Medical imaging
Medicine
Medicine & Public Health
Middle Aged
Muscles
Neuroradiology
Oral cancer
Parameter sensitivity
Parotid gland
Parotid Gland - diagnostic imaging
Parotid Gland - pathology
Parotid Neoplasms - diagnostic imaging
Parotid Neoplasms - pathology
Patients
Permeability
Quantitative analysis
Radiology
Reproducibility of Results
Retrospective Studies
Salivary glands
Sensitivity
Surgery
Tumors
Ultrasound
Validation studies
Young Adult
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Summary:Objectives To determine added value of permeability MRI in parotid tumor characterization to T2-weighted imaging (T2WI), semi-quantitative analysis of time-intensity curve (TIC), and intra-voxel incoherent motion diffusion-weighted imaging (IVIM-DWI). Methods This retrospective study was approved by the institutional review board, and the informed consent was waived. Sixty-one parotid tumors in 61 patients were examined using T2WI, IVIM-DWI, and permeability MRI. TIC patterns were categorized as persistent, washout, or plateau. Signal intensity ratio of lesion-to-muscle on T2WI, apparent diffusion coefficients (ADCs), D and f values from IVIM-DWI, and K trans , k ep , V e , and V p values from permeability MRI were measured. Multiple comparisons were applied to determine whether any differences among 4 histopathologic types (pleomorphic adenomas, Warthin’s tumors, other benign tumors, and malignant tumors) existed. Diagnostic accuracy was compared before and after modification diagnosis referring to permeability MRI. In a validation study, 60 parotid tumors in 60 patients were examined. Results ADC and D values of malignant tumors were significantly lower than those of benign tumors other than Warthin’s tumors, but higher than those of Warthin’s tumors. k ep and V p values of Warthin’s tumors were significantly higher than those of malignant tumors. Multivariate analyses showed that TIC pattern, D , and k ep values were suitable parameters. McNemar’s test showed a significant increase of sensitivity (11/12, 92%) and specificity (46/49, 94%) with adding k ep . The validation study yielded high sensitivity (14/16, 88%) and specificity (41/44, 93%). Conclusion Permeability MRI offers added value to IVIM-MRI and semi-quantitative TIC analysis of DCE-MRI in characterization of parotid tumors Key Points • Permeability MR imaging offers added value in the characterization of parotid gland tumors in combination with semi-quantitative TIC analysis and IVIM analyses with D parameter. • The combination of TIC pattern, D, and k ep might facilitate accurate characterization of parotid gland tumor, thereby avoiding unnecessary surgery for benign tumors or delayed treatment for malignant tumors. • A combination of permeability and diffusion MR imaging can be used to guide the selection of an appropriate biopsy site.
ISSN:0938-7994
1432-1084
DOI:10.1007/s00330-020-07004-3