Differentiation of olfactory neuroblastomas from nasal squamous cell carcinomas using MR diffusion kurtosis imaging and dynamic contrast‐enhanced MRI

Xiao, Zhang; Tang, Zuohua; Qiang, Jin Wei; Qian, Wei-Liang; Zhong, Yuting; Wang, Rong; Wang, Jie; Wu, Lingjie; Tang, Wenlin

doi:10.1002/jmri.25803

Cited by 15 publications

(14 citation statements)

References 34 publications

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“…33 Thus, a high K value may be an efficient indicator of lymphomas. Additionally, ONBs also showed high K values in our cohort, which was in good agreement with a previous study reported by Xiao et al 34 This finding can be explained by the complex microstructure of ONBs, because ONBs are usually separated by the fibrous, vascular, or inflammatory stroma to form the nested appearance within the tumor. Notably, although necrosis and hemorrhage are often respectively seen in SCCs and MMs with increased K values, our results indicated that the K values (complexity) of these two entities were much lower than those of lymphomas and ONBs.…”

Section: Discussionsupporting

confidence: 93%

“…Some patients in the present study cohort overlapped those of our previous studies. 17,26,30,31,34,45 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: Discussionmentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Diffusion Kurtosis Imaging and Intravoxel Incoherent Motion in Differentiating Nasal Malignancies

et al. 2019

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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%

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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“…D app is the diffusion coefficient with correction of ADC value for non-Gaussian bias, which shows inverse correlation to tumor cellular density (21,22). In subgroup analyses, among three most common parotid gland tumors, consistent with previous studies (23), Warthin’s tumors showed the lowest diffusion value of 0.808 ± 0.227 × 10 −3 mm 2 /s, followed by malignant tumors of 0.937 ± 0.250 × 10 −3 mm 2 /s and pleomorphic adenomas of 1.525 ± 0.396 × 10 −3 mm 2 /s, despite the difference between Warthin’s tumors and malignant tumors not reaching statistical significance.…”

Section: Discussionmentioning

confidence: 99%

Preliminary study of using diffusion kurtosis imaging for characterizing parotid gland tumors

Qian

Zhu

et al. 2018

Acta Radiol

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Background Diffusion kurtosis imaging (DKI) is a technique based on the theory that the diffusion of water follows non-Gaussian distribution; until now, few studies have explored the usefulness of DKI in differentiating parotid gland tumors. Purpose To evaluate the potential of DKI in the characterization of parotid gland tumors. Material and Methods DKI was performed in 40 patients with parotid gland tumors (33 benign, 7 malignant). DKI parameters including apparent diffusion coefficient (Dapp) and apparent kurtosis coefficient (Kapp) were obtained using the DK model and compared. Intraclass correlation coefficient (ICC) was used to evaluate inter-observer agreement of DKI derived parameters. Results Excellent inter-observer agreements (Dapp, ICC = 0.988; Kapp, ICC = 0.985) were achieved during quantitative measurements. There were no significant differences in Dapp (P = 0.055) and Kapp (P = 0.915) between the benign and malignant groups. In the subgroup analyses, pleomorphic adenomas showed higher Dapp (P < 0.001) and lower Kapp (P = 0.037) than malignant tumors. Combination of Dapp and Kapp showed optimal discriminative value (area under curve [AUC] = 0.913; sensitivity = 88.89%; specificity = 85.71%). Pleomorphic adenomas also showed higher Dapp (P < 0.001) and lower Kapp (P < 0.001) than Warthin’s tumors. A combination of Dapp and Kapp showed optimal discriminative value (AUC = 1.000; sensitivity = 100%; specificity = 100%). Warthin’s tumors demonstrated higher Kapp than malignant tumors (P < 0.001), while no significant difference was found on Dapp (P = 0.448). The AUC, sensitivity, and specificity of Kapp for discriminating Warthin’s tumors from malignant tumors at an optimal threshold of 0.735 were 0.905, 88.89%, and 85.71%, respectively. Conclusion DKI may be a promising imaging technique for characterizing parotid gland tumors.

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Differentiation of olfactory neuroblastomas from nasal squamous cell carcinomas using MR diffusion kurtosis imaging and dynamic contrast‐enhanced MRI

Abstract: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:354-361.

Cited by 15 publications

References 34 publications

Diffusion Kurtosis Imaging and Intravoxel Incoherent Motion in Differentiating Nasal Malignancies

Diffusion Kurtosis Imaging and Intravoxel Incoherent Motion in Differentiating Nasal Malignancies

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

Preliminary study of using diffusion kurtosis imaging for characterizing parotid gland tumors

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