Imaging quality of PROPELLER diffusion‐weighted MR imaging and its diagnostic performance in distinguishing pleomorphic adenomas from Warthin tumors of the parotid gland

Liu, Yi-Jui; Lee, Yi-Hsiung; Chang, Hing‐Chiu; Chung, Hsiao‐Wen; Wang, Chih‐Wei; Juan, Cheng-Hsuan; Chu, Yueng‐Hsiang; Lee, Jih‐Chin; Juan, Chun-Jung

doi:10.1002/nbm.4282

Cited by 11 publications

(12 citation statements)

References 31 publications

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“… 3 , 4 Therefore, radical surgery is recommended in clinical practice. 5 , 6 However, WTs do not recur and less than 0.1–0.3% of these tumors become malignant. 1 , 7 Limited partial parotidectomy, enucleation, or conservative management are common approaches used for WTs.…”

Section: Introductionmentioning

confidence: 99%

Quantitative Analysis and Pathological Basis of Signal Intensity on T2-Weighted MR Images in Benign and Malignant Parotid Tumors

Wei

Shao

Tian

et al. 2021

CMAR

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To investigate the value of the signal intensity on T2-weighted magnetic resonance (MR) imaging using quantitative analysis in the differentiation of parotid tumors. Materials and Methods: MR data of 80 pleomorphic adenomas (PAs), 68 Warthin tumors (WTs), and 34 malignant tumors (MTs) confirmed by surgery and histology were retrospectively analyzed. The signal intensities of tumor, normal parotid gland, spinal cord, and buccal subcutaneous fat were measured, and the signal intensity ratios (SIRs) between the tumor and the three references were calculated. Receiver operating characteristic curve was used to determine the optimal threshold and diagnostic efficiency of SIR for differentiating PAs, WTs, and MTs. Results: The area under the curve (AUC) of tumor to parotid gland SIR (SIR P ), tumor to spinal cord SIR (SIR C ), and tumor to buccal subcutaneous fat SIR (SIR F ) for differentiating PAs and WTs was 0.922, 0.918, and 0.934, respectively. The sensitivity and specificity at an optimal SIR threshold were 86.3% and 91.2%, 80.0% and 97.1%, and 85.0% and 94.1%, respectively. The AUC of SIR P , SIR C , and SIR F for distinguishing PAs from MTs was 0.793, 0.802, and 0.774, respectively. The sensitivity and specificity at an optimal SIR threshold was 86.3% and 61.8%, 80.0% and 73.5%, and 82.5% and 73.5%, respectively. The AUC of SIR P , SIR C , and SIR F for distinguishing WTs from MTs was 0.716, 0.709, and 0.759, respectively. The sensitivity and specificity at an optimal SIR threshold were 61.8% and 82.4%, 55.9% and 82.4%, and 64.7% and 86.8%, respectively. Conclusion: SIR P , SIR C , and SIR F on T2-weighted MR images had high diagnostic efficiency for differentiating between PAs and WTs, while SIR P and SIR C for differentiating between PAs and MTs, and SIR F for differentiating between WTs and MTs had relatively high diagnostic efficiency.

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Section: Introductionmentioning

confidence: 99%

Quantitative Analysis and Pathological Basis of Signal Intensity on T2-Weighted MR Images in Benign and Malignant Parotid Tumors

Wei

Shao

Tian

et al. 2021

CMAR

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“…Given the complexity of tumor components, the signal intensity in FS-T2WI between BPGT and MPGT might overlap, resulting in low specificity (9,16). FS-T2WI can provide anatomical information on the tumors while ADC maps reflect information on the architecture and density of tumor cells, and CE-T1WI provides information of the tumor local blood supply (8)(9)(10). The combination of these three sequences can reflect the biological information of parotid gland tumors more comprehensively.…”

Section: Discussionmentioning

confidence: 99%

“…Magnetic resonance imaging (MRI) has the characteristics of noninvasive multidirectional imaging and high soft-tissue resolution, which is important when evaluating parotid gland tumors. In MRI sequences, fat-saturated T2weighted imaging (FS-T2WI) can provide anatomical information on the tumor, apparent diffusion coefficients (ADCs) from diffusion-weighted imaging (DWI) can be used to diagnose disease severity by analyzing the diffusion motion of local water molecules, and contrast-enhanced T1-weighted imaging (CE-T1WI) provides information on tumor blood supply (8)(9)(10). Morphological features of the tumor can help differentiate between benign and malignant tumors, including anatomical position (superficial vs. deep), margins, heterogeneous appearance, and infiltration of surrounding tissue, which can be found on MRI.…”

Section: Introductionmentioning

confidence: 99%

Differentiation of Benign From Malignant Parotid Gland Tumors Using Conventional MRI Based on Radiomics Nomogram

Gao

Song

et al. 2022

Front. Oncol.

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ObjectivesWe aimed to develop and validate radiomic nomograms to allow preoperative differentiation between benign- and malignant parotid gland tumors (BPGT and MPGT, respectively), as well as between pleomorphic adenomas (PAs) and Warthin tumors (WTs).Materials and MethodsThis retrospective study enrolled 183 parotid gland tumors (68 PAs, 62 WTs, and 53 MPGTs) and divided them into training (n = 128) and testing (n = 55) cohorts. In total, 2553 radiomics features were extracted from fat-saturated T2-weighted images, apparent diffusion coefficient maps, and contrast-enhanced T1-weighted images to construct single-, double-, and multi-sequence combined radiomics models, respectively. The radiomics score (Rad-score) was calculated using the best radiomics model and clinical features to develop the radiomics nomogram. The receiver operating characteristic curve and area under the curve (AUC) were used to assess these models, and their performances were compared using DeLong’s test. Calibration curves and decision curve analysis were used to assess the clinical usefulness of these models.ResultsThe multi-sequence combined radiomics model exhibited better differentiation performance (BPGT vs. MPGT, AUC=0.863; PA vs. MPGT, AUC=0.929; WT vs. MPGT, AUC=0.825; PA vs. WT, AUC=0.927) than the single- and double sequence radiomics models. The nomogram based on the multi-sequence combined radiomics model and clinical features attained an improved classification performance (BPGT vs. MPGT, AUC=0.907; PA vs. MPGT, AUC=0.961; WT vs. MPGT, AUC=0.879; PA vs. WT, AUC=0.967).ConclusionsRadiomics nomogram yielded excellent diagnostic performance in differentiating BPGT from MPGT, PA from MPGT, and PA from WT.

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“…MRI is superior in displaying the lesion interface and surrounding tissues without ionizing radiation. In the past, the roles of functional MRI, such as diffusion-weighted imaging (DWI) and dynamic contrastenhanced (DCE) MRI, have been evaluated in parotid lesions (4)(5)(6)(7). However, it is still challenging to differentiate benign and malignant lesions based on functional MRI.…”

Section: Introductionmentioning

confidence: 99%

“…Figure4 An APTw image example of non-optimal image quality of normal parotid gland. A 49-year-old male was found with a normal parotid gland of the right side on T2WI (A).…”

mentioning

confidence: 99%

Feasibility evaluation of amide proton transfer-weighted imaging in the parotid glands: a strategy to recognize artifacts and measure APT value

Chen

Wang

et al. 2021

Quant Imaging Med Surg

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Background: The feasibility and image quality of three-dimensional (3D) amide proton transfer (APT)weighted (APTw) in parotid tumor lesions have not been well established in previous studies. This study aimed to evaluate the utility of APT imaging in parotid lesions and glands.Methods: Patients with parotid lesions received 3D turbo spin echo (TSE) APTw on a 3.0T scanner. Two radiologists, who were blinded to the clinical data, independently evaluated the APTw image quality using 4-point Likert scales (1= poor, 4= excellent) in terms of integrity and hyperintensity artifacts. An image quality selection protocol was built based on the two scores. Evaluable images (integrity score >1) and trustable images (integrity score >3 and hyperintensity artifacts score >2) were then enrolled for APTw value comparison between parotid lesions and glands.Results: Forty consecutive patients were included in this study. Four patients were excluded due to severe motion (n=3) or dental (n=1) artifacts, and 36 patients received the APT sequence. Among these, more parotid tumor lesions (34/36, 94.4%) than normal parotid glands (23/31, 74.2%) revealed excellent integrity scores (score =4) (P=0.034). Most parotid tumor lesions (24/34, 70.6%) and glands (16/28, 57.1%) revealed no or little hyperintensity artifacts for diagnosis (scores 3 and 4). APT values of parotid lesions and glands in the evaluable groups were 2.11%±1.15% and 1.60%±1.56%, respectively, and the difference was not significant (P=0.197). APT values of parotid lesions and glands in the trustable groups were 1.99%±1.18% and 1.03%±1.09%, respectively, and the difference was statistically significant (P=0.018).Conclusions: 3D APTw could be used to differentiate parotid tumors and normal parotid glands; however, the technology still needs to be improved to remove artifacts. In our study, most APTw images of tumor lesions in parotid glands had acceptable image quality, and these APTw images are feasible for diagnostic use.

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Imaging quality of PROPELLER diffusion‐weighted MR imaging and its diagnostic performance in distinguishing pleomorphic adenomas from Warthin tumors of the parotid gland

Cited by 11 publications

References 31 publications

Quantitative Analysis and Pathological Basis of Signal Intensity on T2-Weighted MR Images in Benign and Malignant Parotid Tumors

Quantitative Analysis and Pathological Basis of Signal Intensity on T2-Weighted MR Images in Benign and Malignant Parotid Tumors

Differentiation of Benign From Malignant Parotid Gland Tumors Using Conventional MRI Based on Radiomics Nomogram

Feasibility evaluation of amide proton transfer-weighted imaging in the parotid glands: a strategy to recognize artifacts and measure APT value

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