Differentiating between benign and malignant sinonasal lesions using dynamic contrast-enhanced MRI and intravoxel incoherent motion

Jiang, Jingxuan; Xiao, Zhang; Tang, Zuohua; Zhong, Yuting; Qiang, Jin Wei

doi:10.1016/j.ejrad.2017.10.028

Cited by 17 publications

(21 citation statements)

References 35 publications

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“…Some patients in the present study cohort overlapped those of our previous studies . In those studies, we used conventional DWI, IVIM, and DKI with ROI measurements to differentiate benign from malignant sinonasal lesions, to differentiate sinonasal SRCMTs from non‐SRCMTs, to differentiate olfactory neuroblastomas from nasal squamous cell carcinomas, and to correlate different DWI parameters with Ki‐67 labeling index.…”

Section: Acknowledgementmentioning

confidence: 89%

“…IVIM is a biexponential DWI model that is proposed to separate the pure water molecular diffusion from capillary perfusion, and DKI is a non‐Gaussian model of DWI that can evaluate the tissue heterogeneity and cellularity in vivo . Recently, these two advanced DWI models have emerged as efficient tools to differentiate benign from malignant sinonasal lesions, to discriminate sinonasal small round cell malignant tumors (SRCMTs) from non‐SRCMTs, to evaluate the aggressiveness of sinonasal malignancies, and to predict tumor responses to treatment . Nevertheless, the basis of IVIM and DKI with regard to tissue characterization of sinonasal malignant tumors is still unclear, hindering the interpretation and widespread use of these two promising DWI models.…”

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confidence: 99%

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Whole‐tumor histogram analysis of monoexponential and advanced diffusion‐weighted imaging for sinonasal malignant tumors: Correlations with histopathologic features

Xiao

Tang

Zhang

et al. 2019

Magnetic Resonance Imaging

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Background: The histopathological basis of monoexponential diffusion-weighted imaging (DWI), intravoxel incoherent motion (IVIM), and diffusion kurtosis imaging (DKI) in the characterization of sinonasal malignant tumors is still unclear. Purpose: To explore the correlations of histogram metrics from monoexponential DWI, IVIM, and DKI with histopathologic features in sinonasal malignant tumors. Study Type: Retrospective. Subjects: In all, 76 patients with sinonasal malignant tumors. Field Strength/Sequence: Fourteen different b values (b = 0, and 2500 sec/mm 2 ) were used to perform different DWI models at 3.0T. Assessment: The whole-tumor histogram metrics were calculated on the apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudodiffusion coefficient (D*), perfusion fraction (f), diffusion kurtosis (K), and diffusion coefficient (Dk) maps. Histopathologic features, including nuclear, cytoplasmic, cellular, stromal fractions, and the nuclear-to-cytoplasmic (N/C) ratio, were measured. Statistical Tests: Spearman correlations and stepwise multiple linear regression analyses were performed to determine the correlations between histogram metrics and histopathologic features. Results: ADC, Dk, and f histogram metrics showed significant correlations with investigated histopathologic features; D and K histogram metrics were significantly correlated with cellular, stromal, and nuclear fractions (all P < 0.05). Significant correlations between the 75th percentile of D and cytoplasmic fraction and between the kurtosis of K and the N/C ratio were observed (P < 0.05). The skewness of Dk, K, and the 75th percentile of D were independently associated with cellular and nuclear fractions; the skewness of Dk and K were independently associated with stromal fraction (P < 0.05). Data Conclusion: Monoexponential and advanced DWI histogram parameters were significantly correlated with histopathologic features in sinonasal malignancies. Level of Evidence: 3 Technical Efficacy: Stage 2

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Section: Acknowledgementmentioning

confidence: 89%

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confidence: 99%

Whole‐tumor histogram analysis of monoexponential and advanced diffusion‐weighted imaging for sinonasal malignant tumors: Correlations with histopathologic features

Xiao

Tang

Zhang

et al. 2019

Magnetic Resonance Imaging

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“…Nowadays, IVIM has emerged as a useful method to noninvasively assess the neovascularization of malignant tumors that is a critical pathological factor for tumor growth, invasion, and metastasis 2–3 . In this regard, estimation of hemodynamic differences using IVIM may also be predictive of sinonasal malignancies in some histological types 17–26 . Hence, the combination of DKI and IVIM can comprehensively evaluate these three distinctive physiological and pathological features, including tumor cellularity, heterogeneity, and perfusion, and thus may be helpful for the differential diagnosis of different types of sinonasal malignancies.…”

Section: Introductionmentioning

confidence: 99%

“…[14][15][16] Advanced DWI techniques, such as diffusion kurtosis imaging (DKI) and intravoxel incoherent motion (IVIM), can complement physiological information to morphological information that was obtained with conventional MRI. [17][18][19][20][21][22][23][24][25][26] Conventional DWI is a monoexponential Gaussian model, which assumes that water molecule movement follows a Gaussian distribution. [17][18][19][20][21][22][23][24][25][26] However, the complicated microstructures in biological tissues, such as membranes, myelin sheaths, and neural axons, can greatly influence water diffusion within the tissues, suggesting that it is inappropriate to interpret water diffusion using this model.…”

Section: Introductionmentioning

confidence: 99%

Diffusion Kurtosis Imaging and Intravoxel Incoherent Motion in Differentiating Nasal Malignancies

et al. 2019

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Objectives/Hypothesis: To evaluate the usefulness of diffusion kurtosis imaging (DKI) and intravoxel incoherent motion (IVIM) in the differentiation of sinonasal malignant tumors (SNMTs) with different histological types. Study Design: Retrospective observational and diagnostic study. Methods: Sixty-five patients with SNMTs who underwent DKI and IVIM were enrolled in this retrospective study, including 27 squamous cell carcinomas (SCCs), 13 olfactory neuroblastomas (ONBs), 14 malignant melanomas (MMs) and 11 lymphomas. The kurtosis (K) and diffusion coefficient (Dk) from DKI and the pure diffusion coefficient (D), pseudodiffusion coefficient (D*), perfusion fraction (f), and the product of D* and f (fÁD*) from IVIM were measured. Kruskal-Wallis and Dunn multiple comparison tests with Bonferroni correction, receiver operating characteristic curve, and logistic regression analyses were used for statistical analysis. Results: Lymphomas demonstrated the highest K values but lowest Dk, D, D*, f, and fÁD* values among these four malignant tumors. ONBs exhibited high K values and MMs had highest D*, f, and fÁD* values. The cutoff value of ≤0.887 × 10 −3 mm 2 /sec for fÁD* provided a sensitivity, specificity, and an accuracy of 100%, 98.1%, and 98.5%, respectively, for differentiating lymphomas from the other three entities. The combination of fÁD* and D values showed a sensitivity of 92.9% and a specificity of 92.5% for the discrimination of MMs from ONBs and SCCs. The K value was useful for differentiating ONBs from SCCs, with a threshold value of 0.942 (sensitivity, 84.6%; specificity, 63.0%). Conclusions: The combined use of DKI and IVIM is helpful for differentiating among four histological types of SNMTs.

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“…MRI is recommended for soft tissue characterisation; it is useful in patients with complicated inflammatory sinus disease in adjusting the treatment regime (198) . Dynamic contrast enhanced MRI (DCE-MRI) and intravoxel incoherent motion (IVIM) are two MRI techniques that have been shown to effectively differentiate between benign and malignant sinonasal lesions, although biopsy is still required to identify the exact pathology (199) .…”

Section: Magnetic Resonance Imaging (Mri)mentioning

confidence: 99%

European position paper on diagnostic tools in rhinology

Rimmer

Hellings

Lund

et al. 2019

Rhin

114

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is the official Journal of the European and International Rhinologic Societies and appears quarterly in March, June, September and December. Cited in Pubmed, Current Contents, Index Medicus, Exerpta Medica and Embase Founded in 1963 by H.A.E. van Dishoeck, Rhinology is a worldwide non-profit making journal. The journal publishes original papers on basic research as well as clinical studies in the major field of rhinology, including physiology, diagnostics, pathology, immunology, medical therapy and surgery of both the nose and paranasal sinuses. Review articles and short communications are also pulished. All papers are peer-reviewed. Letters-to-the-editor provide a forum for comments on published papers, and are not subject to editorial revision except for correction of English language. In-depth studies that are too long to be included into a regular issue can be published as a supplement. Supple ments are not subject to peer-review.

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Differentiating between benign and malignant sinonasal lesions using dynamic contrast-enhanced MRI and intravoxel incoherent motion

Cited by 17 publications

References 35 publications

Whole‐tumor histogram analysis of monoexponential and advanced diffusion‐weighted imaging for sinonasal malignant tumors: Correlations with histopathologic features

Whole‐tumor histogram analysis of monoexponential and advanced diffusion‐weighted imaging for sinonasal malignant tumors: Correlations with histopathologic features

Diffusion Kurtosis Imaging and Intravoxel Incoherent Motion in Differentiating Nasal Malignancies

European position paper on diagnostic tools in rhinology

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