Value of Diffusion-Weighted Imaging Combined with Susceptibility-Weighted Imaging in Differentiating Benign from Malignant Parotid Gland Lesions

Zhang, Wei; Zuo, Zhichao; Huang, Xiangyang; Jin, Guanqiao; Su, Danke

doi:10.12659/msm.911185

Cited by 13 publications

(16 citation statements)

References 22 publications

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“…Over the past decades, diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE)-MRI and radiomics, have been used to improve the differential diagnosis of PTs [14][15][16][17][18][19]. However, the apparent diffusion coefficient (ADC) value of Warthin tumours (WTs) overlaps with that of malignant tumours, and ADC alone cannot accurately distinguish benign and malignant PTs [14,20].…”

Section: Introductionmentioning

confidence: 99%

“…Intratumoural susceptibility signal (ITSS) is a semi-quantitative measurement of SWI, which has proven to be helpful in the preoperative grading of gliomas, discriminating between lymphoma and glioblastoma [22][23][24]. Preliminary studies have also shown that the addition of SWI can improve the diagnostic efficacy of PTs to some extent [17,18]. In addition, multiparametric MRI, including morphological MRI sequences, DWI, and DCE-MRI, has been used to increase the preoperative diagnostic accuracy in PTs [16,25].…”

Section: Introductionmentioning

confidence: 99%

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Differential diagnosis of parotid gland tumours: Application of SWI combined with DWI and DCE-MRI

Chen

Zheng

et al. 2022

European Journal of Radiology

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Background: Parotid tumours (PTs) have a variety of pathological types, and the surgical procedures differ depending on the tumour type. However, accurate diagnosis of PTs from the current preoperative examinations is unsatisfactory. Methods: This retrospective study was approved by the Ethics Committee of our hospital, and the requirement for informed consent was waived. A total of 73 patients with PTs, including 55 benign and 18 malignant tumours confirmed by surgical pathology, were enrolled. All patients underwent diffusion-weighted imaging (DWI), dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), susceptibility-weighted imaging (SWI), T2weighted imaging (T2WI), and T1-weighted imaging (T1WI). The signal uniformity and capsule on T2WI, apparent diffusion coefficient (ADC) derived from DWI, semi-quantitative parameter time-intensity curve (TIC) pattern, and quantitative parameters including transfer constant (K trans ), extravascular extracellular volume fraction (V e ), wash-out constant (K ep ) calculated from DCE-MRI, and intratumoural susceptibility signal (ITSS) obtained from SWI were assessed and compared between benign and malignant PTs. Logistic regression analysis was used to select the predictive parameters for the classification of benign and malignant parotid gland tumours, and receiver operating characteristic (ROC) curve analysis was used to evaluate their diagnostic performance. Results: Malignant PTs tended to exhibit a type C TIC pattern, whereas benign tumours tended to be type A and B (p < 0.001). Benign PTs had less ITSS than malignant tumours (p < 0.001). Multivariate analyses showed that ADC, V e , and ITSS were predictors of tumour classification. ROC analysis showed that the area under the curve (AUC) of ADC, V e , ITSS, and ADC combined with V e were 0.623, 0.615, 0.826, and 0.782, respectively, in differentiating between malignant and benign PTs. When ITSS was added, the AUCs of ADC, V e , and ADC combined with V e increased to 0.882, 0.848, and 0.930, respectively. Conclusion: SWI offers incremental diagnostic value to DWI and DCE-MRI in the characterisation of parotid gland tumours.; PTs, Parotid tumours; CT, computed tomography; MRI, magnetic resonance imaging; DWI, diffusion-weighted imaging; DCE-MRI, dynamic contrast-enhanced magnetic resonance imaging; ADC, apparent diffusion coefficient; WTs, Warthin tumours; TIC, time-intensity curve; EES, extracellular extravascular space; K trans , volume transfer constant between blood plasma and EES; V e , EES fractional volume; K ep , flux rate constant between the EES and plasma; SWI, susceptibility-weighted imaging; ITSS, intratumoural susceptibility signal; SE-T1WI, spin-echo T1-weighted imaging; SE-T2WI, spin-echo T2-weighted imaging; VIBE, volume interpolated body examination; ROIs, regions of interest; ICC, intra-class correlation coefficient; ROC, receiver operating characteristic; AUC, area under the curve.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Differential diagnosis of parotid gland tumours: Application of SWI combined with DWI and DCE-MRI

Chen

Zheng

et al. 2022

European Journal of Radiology

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“…During our study design, we tried a highly-optimized imaging parameter. Thirty slices with a slice thickness of 3 mm were used in our study, while the slice thickness usually ranged from 4 to 6 mm in previous studies [ 1 , 2 , 25 ]. The voxel size was 1.1 × 1.1 × 3.0 mm 3 , and the average number of each b value was set as 2.…”

Section: Discussionmentioning

confidence: 99%

Feasibility study of using simultaneous multi-slice RESOLVE diffusion weighted imaging to assess parotid gland tumors: comparison with conventional RESOLVE diffusion weighted imaging

Jiang

Zhu

et al. 2020

BMC Med Imaging

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Background: To evaluate the feasibility of using simultaneous multi-slice (SMS) readout segmentation of long variable echo-trains (RESOLVE) diffusion-weighted imaging (DWI) to assess parotid gland tumors, compared with conventional RESOLVE DWI. Methods: From September 2018 to December 2018, 20 consecutive patients with parotid tumors who underwent MRI scan for pre-surgery evaluation were enrolled. SMS-RESOLVE DWI and conventional RESOLVE DWI were scanned with matched imaging parameters, respectively. The scan time of two DWI sequences was recorded. Qualitative (anatomical structure differentiation, lesion display, artifact, and overall image quality) and quantitative (apparent diffusion coefficient, ADC; ratio of signal-to-noise ratio, SNR ratio; ratio of contrast-to-noise ratio, CNR ratio) assessments of image quality were performed, and compared between SMS-RESOLVE DWI and conventional RESOLVE DWI by using Paired t-test. Two-sided P value less than 0.05 indicated significant difference. Results: The scan time was 3 min and 41 s for SMS-RESOLVE DWI, and 5 min and 46 s for conventional RESOLVE DWI. SMS-RESOLVE DWI produced similar qualitative image quality with RESOLVE DWI (anatomical structure differentiation, P = 0.164; lesion display, P = 0.193; artifact, P = 0.330; overall image quality, P = 0.083). Meanwhile, there were no significant difference on ADC Lesion (P = 0.298), ADC Masseter (P = 0.122), SNR ratio (P = 0.584) and CNR ratio (P = 0.217) between two DWI sequences. Conclusion: Compared with conventional RESOLVE DWI, SMS-RESOLVE DWI could provide comparable image quality using markedly reduced scan time. SMS could increase the clinical usability of RESOLVE technique for DWI of parotid gland.

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“…The risk of bias with respect to the reference standard was unclear in all studies [6,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33], as it could not be determined whether the study references had been interpreted without knowledge of the index test results. The risk of bias with respect to flow and timing was rated high in four studies with multiple subsets [19,25,29,34], and one subset was selected from each to prevent oversampling. The risk of bias with respect to flow and timing was rated unclear in nine studies [6,[20][21][22][23][24]26,28,32] because either the same reference standards were not used or the interval between the index test and reference standard was not reported.…”

Section: Methodological Quality Assessmentmentioning

confidence: 99%

“…To date, an increasing number of studies have attempted to determine the usefulness of DWI for the diagnosis of parotid lesions. Although some studies attempted to set cut-off values for differentiating parotid gland malignancies from benign lesions, these have yielded controversial results [15][16][17]. Therefore, we aimed to perform a systematic review and meta-analysis to clarify the diagnostic performance of DWI for characterizing malignancies of the parotid gland.…”

Section: Introductionmentioning

confidence: 99%

Performance of diffusion-weighted imaging for the diagnosis of parotid gland malignancies: A meta-analysis

Chen

Liu

Tang

et al. 2021

European Journal of Radiology

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This study aimed to assess the diagnostic performance of diffusion-weighted imaging (DWI) for parotid gland malignancies. Methods: Four databases (PubMed, the Cochrane Library, Embase, and Web of Science) were searched systematically and retrospectively by two researchers until May 18, 2020. The methodological quality of the studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A bivariate random effects model was used to pool the sensitivity and specificity data for the apparent diffusion coefficient (ADC). Summary receiver operating characteristic curve was constructed, and the area under the curve (AUC) was calculated. The positive (LR+) and negative likelihood ratios (LR-) were also calculated. Subgroup and meta-regression analyses were performed to evaluate heterogeneity within studies. Results: Sixteen studies involving 1004 patients were included. The pooled sensitivity, specificity, and AUC for the ADC to distinguish malignant from begin parotid lesions were 89 %, 76 %, and 0.91, respectively. The LR + was 3.7 and LR-was 0.15, respectively. Subgroup analyses revealed that the applied cut-off b values and study size were sources of heterogeneity for the ADC. There were publication bias concerns. Conclusions: Our meta-analysis suggests that the ADC value provides excellent sensitivity and moderate specificity for the diagnosis of malignant lesions in the parotid gland. However, substantial heterogeneity was found. Therefore, additional larger, prospective studies in combination with standard techniques focusing on parotid tumors should be conducted to determine the true performance of DWI for the differential diagnosis of parotid lesions.

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Value of Diffusion-Weighted Imaging Combined with Susceptibility-Weighted Imaging in Differentiating Benign from Malignant Parotid Gland Lesions

Cited by 13 publications

References 22 publications

Differential diagnosis of parotid gland tumours: Application of SWI combined with DWI and DCE-MRI

Differential diagnosis of parotid gland tumours: Application of SWI combined with DWI and DCE-MRI

Feasibility study of using simultaneous multi-slice RESOLVE diffusion weighted imaging to assess parotid gland tumors: comparison with conventional RESOLVE diffusion weighted imaging

Performance of diffusion-weighted imaging for the diagnosis of parotid gland malignancies: A meta-analysis

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