Malignant Tumors and Chronic Infections in the Masticator Space: Preliminary Assessment with In Vivo Single-Voxel<sup>1</sup>H-MR Spectroscopy

Yu, Qiang; Yang, Jie; Wang, P.

doi:10.3174/ajnr.a0897

Cited by 15 publications

(9 citation statements)

References 14 publications

(35 reference statements)

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“…The criterion followed the 1 H MRS study by Yu et al . . Considering all lesions with a choline SNR larger than 3.0 to be malignant, we obtained a sensitivity of 66.3% (65 of 98; 95% CI, 56.5–74.9%), a specificity of 79.5% (89 of 112; 95% CI, 71.1–85.9%), a positive predictive value of 73.9% (65 of 88; 95% CI, 63.8–81.9%) and a negative predictive value of 73.0% (89 of 122; 95% CI, 64.5–80.0%) (Table ).…”

Section: Resultsmentioning

confidence: 78%

“…A number of studies using in vivo 1 H MRS have shown that choline signals are found not only in malignant tumors, but also in benign abnormalities which may be metabolically active or hypercellular in brain, head and neck, ovarian, breast, adrenal, and bone and soft-tissue lesions (10,13,(16)(17)(18)(19)(20)(21). In addition, inflammatory cells may result in a high choline peak (22).…”

Section: Discussionmentioning

confidence: 99%

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In vivo¹H MRS for musculoskeletal lesion characterization: which factors affect diagnostic accuracy?

Wang

Hsieh

et al. 2011

NMR in Biomedicine

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In vivo (1)H MRS is a noninvasive imaging technique for the identification of malignancy. Musculoskeletal lesions vary in their composition, causing field inhomogeneity and magnetic susceptibility effects which may be technical and diagnostic challenges for MRS. This study investigated the factors that affect diagnostic accuracy in the use of MRS for the characterization of musculoskeletal neoplasms. During a 7-year period, 210 consecutive patients with musculoskeletal lesions larger than 1.5 cm in diameter were examined. MRS of a single-voxel point-resolved spectroscopy sequence with TE = 135 ms was undertaken using a 1.5-T scanner. Lesions with a choline signal-to-noise ratio larger than 3.0 were considered to be malignant tumors. The diagnostic accuracy was calculated for all lesions and for subgroups on the basis of lesion type (bone and soft tissue), lesion composition (mixed and solid nonsclerotic), lesion size (≤4, >4-10 and >10 cm), MR scanner (MR scanner 1 and 2) and selected voxel size (≤3, >3-8 and >8 cm(3)). Multivariate logistic regressions were performed to estimate the associations between each factor and diagnostic accuracy. The diagnostic accuracy was 73.3% for all lesions. The accuracy was 54.4% for mixed lesions and 80.4% for solid nonsclerotic lesions (p < 0.001). The diagnostic accuracy was lower for larger lesions [86.8% for lesions of ≤4 cm, 71.6% for lesions of >4-10 cm (p = 0.04) and 63.6% for lesions of >10 cm (p = 0.007)]. There was no difference in diagnostic accuracy for bone versus soft-tissue lesions or as a function of MR scanner or voxel size. By the use of multivariate logistic regression, a solid nonsclerotic lesion was 3.15 times (95% confidence interval, 1.59-6.27) more likely than a mixed lesion to have a diagnosis (p = 0.001). MRS can be used to characterize musculoskeletal lesions, particularly solid nonsclerotic lesions.

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Section: Resultsmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

In vivo¹H MRS for musculoskeletal lesion characterization: which factors affect diagnostic accuracy?

Wang

Hsieh

et al. 2011

NMR in Biomedicine

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“…Diffusion-weighted imaging can be valuable in distinguishing between benign solid and malignant tumours [7], and MR spectroscopy may be potentially useful in the differentiation of chronic infections from malignant tumours of the space [8]. The clinical value of these techniques has not yet been shown, and more studies are necessary before their usefulness can be ascertained.…”

Section: Imaging Of the Masticator Spacementioning

confidence: 99%

Anatomy and pathology of the masticator space

et al. 2013

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ObjectiveThis article reviews and illustrates the anatomy and pathology of the masticator space (MS).BackgroundPathology of the masticator space includes inflammatory conditions, vascular lesions, and tumours. Intrinsic tumours of this space can be benign and malignant, and they may arise from the mandibular ramus, the third division of the trigeminal nerve, or the mastication muscles. Malignant tumours may appear well defined and confined by the masticator fascia, without imaging signs of aggressive extension into neighbouring soft tissues. Secondary invasion of the masticator space can also occur with tumours of the nasopharynx, oropharynx, oral cavity, and parotid glands. Perineural tumour spread (PNS), especially along the trigeminal nerve, can also occur with masticator space malignancies.ConclusionMasses of the MS are difficult to evaluate clinically, and computed tomographic (CT) and magnetic resonance (MR) images are essential for the diagnosis and characterisation of these lesions. Malignant tumours may appear well defined and confined by the fascia. Thus, when a mass is identified, a biopsy should be done promptly. PNS may occur in tumours involving the MS and its recognition on imaging studies is essential to plan the appropriate treatment.Teaching points• Differentiating between intrinsic and extrinsic lesions is essential to the differential diagnosis• Infections of the MS may cross the fascia and mimic neoplasms on imaging studies• Malignant tumours may show no aggressive signs, such as bone erosion or violation of the fascia• Perineural spread (PNS) is often clinically silent and frequently missed at imaging and leads to tumour recurrence

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“…Malignancy reveals restricted diffusion with low ADC value compared to inflammatory lesions at diffusion [7][8][9]. There is a significant difference in the choline signals and choline/ creatine between malignant tumors and inflammatory lesions of the masticator space [10].…”

Section: Differentiating Malignancy From Inflammatory Lesionsmentioning

confidence: 99%

“…Diffusion MR imaging has been used to differentiate malignant tumors of the masticator space from benign lesions [7] and infection [8], as well as for differentiation of recurrent tumors from post-treatment changes [9]. MR spectroscopy has a role in differentiation of chronic infection from malignancy, but of limited value [10]. Dynamic contrast-enhanced MR imaging and dynamic susceptibility-weighted contrast-enhanced MR imaging also show promise for characterizing space soft tissue tumors of the masticator space [3,11].…”

Section: Magnetic Resonance (Mr) Imagingmentioning

confidence: 99%

Computed tomography and magnetic resonance imaging of lesions at masticator space

Razek

2014

Jpn J Radiol

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We aim to review the normal anatomy and imaging appearance of masticator space lesions. Because the masticator space is not amenable to direct examination, cross-sectional imaging with computed tomography and magnetic resonance imaging play an important role in diagnosis and characterization of lesions occurring there. Masticator space lesions can be classified on the basis of their origin into the following categories: inflammatory lesions, benign tumors, malignant tumors, vascular lesions, and developmental lesions. A diverse spectrum of malignant tumors and benign lesions are seen extending from the adjacent spaces. In addition, one should also be familiar with pseudolesions as well as post-treatment changes in the masticator space that can be mistaken for pathologic conditions.

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Malignant Tumors and Chronic Infections in the Masticator Space: Preliminary Assessment with In Vivo Single-Voxel¹H-MR Spectroscopy

Abstract: BACKGROUND AND PURPOSE:Differential diagnosis between malignant tumors and chronic infections in the masticator space remains challenging. The purpose of the study was to categorize various changes of both lesions by using single-voxel 1 H-MR spectroscopy.

Cited by 15 publications

References 14 publications

In vivo¹H MRS for musculoskeletal lesion characterization: which factors affect diagnostic accuracy?

In vivo¹H MRS for musculoskeletal lesion characterization: which factors affect diagnostic accuracy?

Anatomy and pathology of the masticator space

Computed tomography and magnetic resonance imaging of lesions at masticator space

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Malignant Tumors and Chronic Infections in the Masticator Space: Preliminary Assessment with In Vivo Single-Voxel1H-MR Spectroscopy

Abstract: BACKGROUND AND PURPOSE:Differential diagnosis between malignant tumors and chronic infections in the masticator space remains challenging. The purpose of the study was to categorize various changes of both lesions by using single-voxel 1 H-MR spectroscopy.

Cited by 15 publications

References 14 publications

In vivo1H MRS for musculoskeletal lesion characterization: which factors affect diagnostic accuracy?

In vivo1H MRS for musculoskeletal lesion characterization: which factors affect diagnostic accuracy?

Anatomy and pathology of the masticator space

Computed tomography and magnetic resonance imaging of lesions at masticator space

Contact Info

Product

Resources

About

Malignant Tumors and Chronic Infections in the Masticator Space: Preliminary Assessment with In Vivo Single-Voxel¹H-MR Spectroscopy

In vivo¹H MRS for musculoskeletal lesion characterization: which factors affect diagnostic accuracy?

In vivo¹H MRS for musculoskeletal lesion characterization: which factors affect diagnostic accuracy?