Clinical and demographic data improve diagnostic accuracy of dynamic contrast-enhanced and diffusion-weighted MRI in differential diagnostics of parotid gland tumors

Mikaszewski, Bogusław; Markiet, Karolina; Smugała, Aneta; Stodulski, Dominik; Szurowska, Edyta; Stankiewicz, Czesław

doi:10.1016/j.oraloncology.2020.104932

Cited by 7 publications

(9 citation statements)

References 21 publications

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“…The highest sensitivity and specificity were 84.2% and 91.9%. They combined T peak , WR, ADC value in diagnosis Warthin’s tumor from malignant tumor, which the sensitivity and specificity were lower than our study [ 28 ]. TTP is known to correlate inversely with microvessel density in the examined tissue, and WOR was shown to increase proportionally to the amount of connective tissue within the lesion [ 29 ].…”

Section: Discussioncontrasting

confidence: 68%

“…The malignant parotid tumor group showed a significantly lower value on 10th TTP and a higher value on skewness MRE than the benign tumor group except for the Warthin’s tumor group. Compared with previous studies [ 9 , 28 ], most of them compared pleomorphic adenoma with malignant tumor, whether ADC histogram or dynamic enhanced MRI parameters were used. However, ADC mean , T peak which commonly used in clinic does not show good sensitivity and specificity.…”

Section: Discussionmentioning

confidence: 99%

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Histogram analysis of dynamic contrast-enhanced magnetic resonance imaging in the differential diagnosis of parotid tumors

et al. 2021

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Objective Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) histograms were used to investigate whether their parameters can distinguish between benign and malignant parotid gland tumors and further differentiate tumor subgroups. Materials and methods A total of 117 patients (32 malignant and 85 benign) who had undergone DCE-MRI for pretreatment evaluation were retrospectively included. Histogram parameters including mean, median, entropy, skewness, kurtosis and 10th, 90th percentiles were calculated from time to peak (TTP) (s), wash in rate (WIR) (l/s), wash out rate (WOR) (l/s), and maximum relative enhancement (MRE) (%) mono-exponential models. The Mann–Whitney U test was used to compare the differences between the benign and malignant groups. The diagnostic value of each significant parameter was determined on Receiver operating characteristic (ROC) analysis. Multivariate stepwise logistic regression analysis was used to identify the independent predictors of the different tumor groups. Results For both the benign and malignant groups and the comparisons among the subgroups, the parameters of TTP and MRE showed better performance among the various parameters. WOR can be used as an indicator to distinguish Warthin’s tumors from other tumors. Warthin’s tumors showed significantly lower values on 10th MRE and significantly higher values on skewness TTP and 10th WOR, and the combination of 10th MRE, skewness TTP and 10th WOR showed optimal diagnostic performance (AUC, 0.971) and provided 93.12% sensitivity and 96.70% specificity. After Warthin’s tumors were removed from among the benign tumors, malignant parotid tumors showed significantly lower values on the 10th TTP (AUC, 0.847; sensitivity 90.62%; specificity 69.09%; P < 0.05) and higher values on skewness MRE (AUC, 0.777; sensitivity 71.87%; specificity 76.36%; P < 0.05). Conclusion DCE-MRI histogram parameters, especially TTP and MRE parameters, show promise as effective indicators for identifying and classifying parotid tumors. Entropy TTP and kurtosis MRE were found to be independent differentiating variables for malignant parotid gland tumors. The 10th WOR can be used as an indicator to distinguish Warthin’s tumors from other tumors.

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Section: Discussioncontrasting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Histogram analysis of dynamic contrast-enhanced magnetic resonance imaging in the differential diagnosis of parotid tumors

et al. 2021

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“… 14 Their team further differentiated MTs from PAs and WTs, with sensitivity of 88.9–94.4%, specificity of 88.9%–96.4%, and AUC of 0.949–0.969. 18 However, in some other studies, DWI and DCE-PWI were difficult to distinguish MTs from WTs. 2 , 7 , 17 , 20 It can be seen that these parameters have incomplete reproducibility and reliability, and a large sample size in more centers are needed.…”

Section: Discussionmentioning

confidence: 95%

“…Although DCE-PWI and DWI can respectively differentiating parotid tumors by semiquantitative and quantitative analyses of time-intensity curve pattern and apparent diffusion coefficient values, there are relatively large inter-study differences in results, or standardization is still lacking. 7,14,[17][18][19] Besides, the interobserver variation and limited availability of the examinations seem to be potential obstacles to their widespread use. 13,14 T2-weighted imaging, as a conventional sequence, can be used in all field strength equipment.…”

Section: Introductionmentioning

confidence: 99%

Quantitative Analysis and Pathological Basis of Signal Intensity on T2-Weighted MR Images in Benign and Malignant Parotid Tumors

Wei

Shao

Tian

et al. 2021

CMAR

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To investigate the value of the signal intensity on T2-weighted magnetic resonance (MR) imaging using quantitative analysis in the differentiation of parotid tumors. Materials and Methods: MR data of 80 pleomorphic adenomas (PAs), 68 Warthin tumors (WTs), and 34 malignant tumors (MTs) confirmed by surgery and histology were retrospectively analyzed. The signal intensities of tumor, normal parotid gland, spinal cord, and buccal subcutaneous fat were measured, and the signal intensity ratios (SIRs) between the tumor and the three references were calculated. Receiver operating characteristic curve was used to determine the optimal threshold and diagnostic efficiency of SIR for differentiating PAs, WTs, and MTs. Results: The area under the curve (AUC) of tumor to parotid gland SIR (SIR P ), tumor to spinal cord SIR (SIR C ), and tumor to buccal subcutaneous fat SIR (SIR F ) for differentiating PAs and WTs was 0.922, 0.918, and 0.934, respectively. The sensitivity and specificity at an optimal SIR threshold were 86.3% and 91.2%, 80.0% and 97.1%, and 85.0% and 94.1%, respectively. The AUC of SIR P , SIR C , and SIR F for distinguishing PAs from MTs was 0.793, 0.802, and 0.774, respectively. The sensitivity and specificity at an optimal SIR threshold was 86.3% and 61.8%, 80.0% and 73.5%, and 82.5% and 73.5%, respectively. The AUC of SIR P , SIR C , and SIR F for distinguishing WTs from MTs was 0.716, 0.709, and 0.759, respectively. The sensitivity and specificity at an optimal SIR threshold were 61.8% and 82.4%, 55.9% and 82.4%, and 64.7% and 86.8%, respectively. Conclusion: SIR P , SIR C , and SIR F on T2-weighted MR images had high diagnostic efficiency for differentiating between PAs and WTs, while SIR P and SIR C for differentiating between PAs and MTs, and SIR F for differentiating between WTs and MTs had relatively high diagnostic efficiency.

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“…Multiparametric magnetic resonance imaging (mpMRI) gains recognition in the diagnostic algorithm of salivary gland tumors, providing data from different diffusion-weighted imaging (DWI) models and dynamic contrast enhanced sequences (DCE-MRI) [5][6][7][8][9]. Diffusion-weighted imaging reflects the cell density of the tissue.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of Intravoxel Incoherent Motion (IVIM) and Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) in Differentiation of Benign Parotid Gland Tumors

Markiet

Glińska

Nowicki

et al. 2022

Biology

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Aim: The aim of this prospective study is to identify quantitative intravoxel incoherent motion and dynamic contrast-enhanced magnetic resonance imaging parameters of the most frequent benign parotid tumors, compare their utility and diagnostic accuracy. Methods: The study group consisted of 52 patients with 64 histopathologically confirmed parotid focal lesions. Parametric maps representing apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (FP) and transfer constant (Ktrans), reflux constant (Kep), extra-vascular extra-cellular volume fraction (Ve), and initial area under curve in 60 s (iAUC) have been obtained from multiparametric MRI. Results: Statistically significant (p < 0.001) inter-group differences were found between pleomorphic adenomas (PA) and Warthin tumors (WT) in all tested parameters but iAUC. Receiver operating characteristic curves were constructed to determine the optimal cut-off levels of the most significant parameters allowing differentiation between WT and PA. The Area Under the Curve (AUC) values and thresholds were for ADC: 0.931 and 1.05, D: 0.896 and 0.9, Kep: 0.964 and 1.1 and Ve: 0.939 and 0.299, respectively. Lesions presenting with a combination of ADC, D, and Ve values superior to the cut-off and Kep values inferior to the cut-off are classified as pleomorphic adenomas. Lesions presenting with combination of ADC, D, and Ve values inferior to the cut-off and Kep values superior to the cut-off are classified as Warthin tumors. Conclusions: DWI, IVIM and quantitative analysis of DCE-MRI derived parameters demonstrated distinctive features of PAs and WT and as such they seem feasible in differentiation of benign parotid gland tumors.

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Clinical and demographic data improve diagnostic accuracy of dynamic contrast-enhanced and diffusion-weighted MRI in differential diagnostics of parotid gland tumors

Cited by 7 publications

References 21 publications

Histogram analysis of dynamic contrast-enhanced magnetic resonance imaging in the differential diagnosis of parotid tumors

Histogram analysis of dynamic contrast-enhanced magnetic resonance imaging in the differential diagnosis of parotid tumors

Quantitative Analysis and Pathological Basis of Signal Intensity on T2-Weighted MR Images in Benign and Malignant Parotid Tumors

Feasibility of Intravoxel Incoherent Motion (IVIM) and Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) in Differentiation of Benign Parotid Gland Tumors

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