Diagnostic value of CT perfusion imaging for parotid neoplasms

Abstract

Objectives: To assess the value of CT perfusion imaging in the differentiation of different histological categorization of benign tumours from malignant tumours in patients with parotid neoplasms. Methods: CT perfusion was successfully performed in 62 patients with parotid neoplasms whose diagnoses were confirmed by surgery or biopsy. The software generated a tissue time-density curve (TDC) and measured blood volume, blood flow, mean transit time and capillary permeability surface product. One-way ANOVA and receiver operating characteristic curves were used to analyse the difference and diagnostic efficacies of all perfusion data between each one of the benign tumours and malignancies. Statistical significance was assigned at the 5% level. Results: Pleomorphic adenomas mainly had a gradually ascending TDC. Warthin tumours showed a fast ascent followed by a fast descent. The TDC of basal cell adenomas had a fast ascension followed by a plateau, then a gradual descent. Malignant tumours mainly showed a rapidly ascending curve with a stable plateau. Significant differences were observed in blood flow, blood volume and mean transit time between pleomorphic adenomas and malignant tumours (p , 0.05) as well as in blood flow and blood volume between the Warthin tumours, the basal cell adenomas and the malignant tumours (p , 0.05). Differences in permeability surface between the basal cell adenomas and malignant tumours were significant (p , 0.01). Conclusion: CT perfusion of parotid gland could provide TDC and perfusion data, which were useful in the differentiation of different histological benign tumours and malignant tumours in the parotid gland.

Pleomorphic Adenoma Versus Warthin Tumor of the Parotid Gland: Diagnostic Value of CT Perfusion Imaging and Its Pathologic Explanation

“…When compared with dualphased enhanced CT, we assumed that Type I TDC was similar to early increase and fast decrease, and type III TDC were similar to delayed enhancement. The TDC findings features for WTs and PAs in this study strongly supported the previous opinions [9][10][11][12][13]15] , but some differences were also depicted. Type II TDC for 2 WTs cases observed in present work, showed fast enhancement and gradual washout, which was similar to type C TDC described by Y Dong et al [10] .…”

“…In additional, previous study had revealed false teeth could affect the CTP results [10] . In this study, 2 cases with false teeth resulting in low quantify TDC, were also excluded.…”

“…Therefore, CTP can reflect the blood flow within tissue directly, truly and reliably [9,12,13] . Previous studies [9][10][11][12][13] demonstrated that CTP imaging was usefulness to evaluate the vasclarituy and to differential the tumors in the head and neck, including those of the salivary glands. TDC and perfusion parameters such as BV, BF and TTP were main indexes for analysis in CT perfusion.…”

“…There is evidence that TDC curves, BF, BV, TTP and PEI parameters can help objectively evaluate the microcirculation and tumor vessel formation and reflect the pathohistological characteristics of foci, and BF, BV and PEI can be used to effectively evaluate micro-vessel density and tumor angiogenesis [9,12,13] . Y Dong et al [10] and Bisdas S. et al [15] studies demonstrated that TDC pattern was very helpful for parotid tumor differential diagnosis. TCD findings in this study were classified into three types, type I TDC represented fast enhancement and fast washout, most of WTs showed this type.…”

“…Based on previous literatures [9][10][11] , it is known that washout time (or washout ratio) of contrast agents in the tumors could provide many valuable physiopathology information and help to differential diagnosis among of pariod gland lesions. Between PAs and WTs, quickly expurgation of contrast material was unique for WTs, and a delayed enhancement for PAs, but the results were not accepted completely.…”