Improving diagnostic performance of differentiating ocular adnexal lymphoma and idiopathic orbital inflammation using intravoxel incoherent motion diffusion-weighted MRI

Jiang, Hong; Wang, Shijun; Li, Zheng; Xie, Lizhi; Wei, Wenbin; Ma, Jianmin; Jian, Xian

doi:10.1016/j.ejrad.2020.109191

Cited by 10 publications

(14 citation statements)

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“…23 Several publications have assessed DWI-MRI for distinction between benign and malignant orbital masses based on ADC values. [14][15][16][17] Malignant masses, especially orbital lymphomas, have been associated with visually and quantitatively lower ADC-values as compared to benign masses. [14][15][16][17] Among our patients, only five had MRI-examinations, and only one of those underwent DWI-imaging.…”

Section: Discussionmentioning

confidence: 99%

“…In the literature, the apparent diffusion coefficient (ADC) at diffusion-weighted MRI-imaging (DWI) has been significantly lower for lymphoma in comparison to orbital inflammation in general, 14,15 and IgG4-ROD in particular, in limited patient collectives. 16,17 Early recognition of IgG4-ROD and distinction from OAL is desirable for clinical management, especially in lesions that are small in size or in a posterior location that is risky for biopsy.…”

Section: Introductionmentioning

confidence: 99%

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Morphologic Cross-Sectional Imaging Features of IgG4-Related Orbitopathy in Comparison to Ocular Adnexal Lymphoma

Klingenstein

Garip‐Kuebler

Priglinger

et al. 2021

OPTH

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Aim To detect radiological features that, in addition to clinical findings, may aid in correct differentiation between IgG4-related ophthalmic disease (IgG4-ROD) and ocular adnexal lymphoma (OAL). Methods In this retrospective, single-center, comparative analysis, we compared cross-sectional imaging findings of 13 consecutive patients with histologically proven IgG4-ROD and a control group of 29 consecutive OAL-patients diagnosed between 10/2014 and 09/2019. Statistical significance was accepted at a p <0.05 significance level. Results IgG4-ROD-patients had longer time-to-diagnosis, higher orbital recurrence rates, but smaller lesions compared to OAL-patients ( p =0.002; p =0.006 and p =0.006; Mann–Whitney U -test). Frequent cross-sectional imaging findings in both IgG4-ROD-patients and OAL-patients included extraocular muscle enlargement (92% and 93%, respectively; most often in the lateral rectus muscles and the levator-complex), and lacrimal-gland enlargement (85% and 83%, respectively). Other imaging findings comprised infraorbital nerve-involvement (IgG4-ROD, 23%, OAL, 17%) and orbital fat inflammation (IgG4-ROD, 23%, OAL, 28%). Bony infiltration and remodeling, heterogenous contrast-media distribution, and infiltration of the lacrimal system were seen slightly more often in IgG4-ROD (23%, 38%, 15% and 15% versus 17%, 14%, 3% and 7%). However, cross-sectional imaging features did not differ significantly between patient subgroups. Clinical symptoms predominantly occurred unilaterally (IgG4-ROD, 9/13, 69%, OAL, 24/29, 83%), while imaging findings were most often bilateral (IgG4-ROD, 11/13, 85%, OAL, 23/29, 79%, p <0.001, McNemar test). Conclusion No morphological cross-sectional imaging sign could reliably distinguish between IgG4-ROD and OAL, leaving histopathology indispensable for definite diagnosis. Yet, importantly, for both IgG4-ROD and OAL, cross-sectional imaging frequently detected bilateral orbital disease when only one eye was clinically affected.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Morphologic Cross-Sectional Imaging Features of IgG4-Related Orbitopathy in Comparison to Ocular Adnexal Lymphoma

Klingenstein

Garip‐Kuebler

Priglinger

et al. 2021

OPTH

View full text Add to dashboard Cite

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“…IVIM-DWI parameters such as true diffusion coefficient (D) and perfusion fraction (f) as well as mean ADC values are significantly lower in lymphoma. 27,28…”

Section: Orbitmentioning

confidence: 99%

Autoimmune disease of head and neck, imaging, and clinical review

et al. 2022

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Autoimmune disease of the head and neck (H&N) could be primary or secondary to systemic diseases, medications, or malignancies. Immune-mediated diseases of the H&N are not common in daily practice of radiologists; the diagnosis is frequently delayed because of the non-specific initial presentation and lack of familiarity with some of the specific imaging and clinical features. In this review, we aim to provide a practical diagnostic approach based on the specific radiological findings for each disease. We hope that our review will help radiologists expand their understanding of the spectrum of the discussed disease entities, help them narrow the differential diagnosis, and avoid unnecessary tissue biopsy when appropriate based on the specific clinical scenarios.

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“…Idiopathic orbital inflammatory pseudotumors (IOIPs) are a non-specific type of orbital inflammatory disease. Orbital inflammatory disease is the third most prevalent type of orbital lesion ( 1 ), accounting for 9% of cases ( 2 ). According to the different proportions of chronic inflammatory cell infiltration and fibrous tissue hyperplasia in the pathological tissues, IOIP can be classified into a diffuse lymphocytic infiltration type, a mixed type, and a fibrosclerotic type ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

“…Taking readings of these measures can provide a comprehensive picture of the quantitative parameters of water molecule movement in tissue cells and blood microcirculation, and the procedure does not interfere with the diffusion movement of water molecules outside tissue cells (23). IVIM-DWI has high diagnostic and differential diagnostic value for liver, kidney, and pancreatic diseases (24)(25)(26), and it is a reliable method for distinguishing orbital lymphoma and IOIPs (1).…”

Section: Introductionmentioning

confidence: 99%

Correlation Between IVIM-DWI Parameters and Pathological Classification of Idiopathic Orbital Inflammatory Pseudotumors: A Preliminary Study

Liang

Qian

et al. 2022

Front. Oncol.

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ObjectiveTo investigate the correlation between intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and the pathological classification of idiopathic orbital inflammatory pseudotumors (IOIPs).MethodsNineteen patients who were diagnosed with IOIPs (a total of 24 affected eyes) between November 2018 and December 2020 were included in the study. All the patients underwent magnetic resonance imaging orbital plain scans and IVIM-DWI multiparameter scans before an operation. The true diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) values were obtained. Based on histopathology, the lesions were divided into three types: lymphocytic infiltration, fibrosclerotic, and mixed. The correlation between IVIM-DWI parameters and pathological classification was tested with the histopathological results as the gold standard. The data were analyzed using SPSS version 17.0, with P < 0.05 defined as significant.ResultsAmong the 19 patients (24 eyes) affected by IOIP, there were no significant differences between IOIP pathological classification and gender or age (P > 0.05). There were statistically significant differences between the D and f values for different pathological types of IOIP and IVIM parameters (P < 0.05), and there was no significant difference in D* value between the different pathological types (P > 0.05).ConclusionThe D and f values showed correlation with different types of IOIP, and the sensitivity of the D value was higher than that of the f value. The D* value showed no significant distinction between pathological types of IOIP.

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Improving diagnostic performance of differentiating ocular adnexal lymphoma and idiopathic orbital inflammation using intravoxel incoherent motion diffusion-weighted MRI

Cited by 10 publications

References 35 publications

Morphologic Cross-Sectional Imaging Features of IgG4-Related Orbitopathy in Comparison to Ocular Adnexal Lymphoma

Morphologic Cross-Sectional Imaging Features of IgG4-Related Orbitopathy in Comparison to Ocular Adnexal Lymphoma

Autoimmune disease of head and neck, imaging, and clinical review

Correlation Between IVIM-DWI Parameters and Pathological Classification of Idiopathic Orbital Inflammatory Pseudotumors: A Preliminary Study

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