Role of dynamic contrast enhanced MR perfusion in differentiation between benign and malignant tumors

Backry, Magda El; Shady, Magda; Mousa, Amani Ezzat; Zaky, Mona

doi:10.1016/j.ejrnm.2015.01.001

Cited by 5 publications

(4 citation statements)

References 23 publications

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“…El Backry et al 17 studied the role of DCE‐MRI in differentiating benign from malignant head and neck neoplasms with a sample size of 55 patients wherein they found 82% of the benign tumors showing gradual progressing and plateau curves, whereas 93% of malignant tumors displayed plateau and fast curves. Among the evaluated perfusion parameters, wash‐in rate with a cutoff value of 15.4/s (sensitivity: 87.9%, specificity: 90.0%) was adjudged as the best parameter for differentiating benign from malignant tumors.…”

Section: Discussionmentioning

confidence: 99%

Dynamic contrast‐enhanced magnetic resonance imaging for differentiating head and neck paraganglioma and schwannoma

et al. 2021

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Background and Purpose Morphological assessment with conventional magnetic resonance imaging (MRI) sequences has limited specificity to distinguish between paragangliomas and schwannomas. Assessing the differences in microvascular properties through pharmacokinetic parameters of dynamic contrast‐enhanced (DCE)‐MRI can provide additional information to aid in this differentiation. Materials and Methods A prospective study on MR characterization of neck masses was performed between January 2017 and March 2019 in our department, out of which 40 patients with head and neck paragangliomas (HNPGLs) (33 lesions) and schwannomas (15 lesions) were included in this analysis. MR perfusion using dynamic axial T1WI fat suppressed fast spoiled gradient recalled sequence with parallel imaging was performed in all the patients, in addition to single‐shot turbo spin‐echo axial diffusion weighted imaging (DWI) and routine MRI. ROI‐based method was used to obtain signal‐time curves, permeability measurements, and mean apparent diffusion coefficient (ADC) to differentiate paragangliomas from schwannomas. Statistical analysis was done to assess the significance and establish a cutoff to distinguish between the two entities. The available images of DOTANOC PET/CT (34 lesions) were analyzed retrospectively. Correlations between the perfusion, diffusion, and molecular PET/CT parameters were done. Results Paragangliomas had a higher wash‐in rate, wash‐out rate, Ktrans, Kep, and Vp (p < 0.001); while schwannomas had a higher relative enhancement (p < 0.012), time to peak, time of onset, brevity of enhancement, and Ve (p < 0.001). Among the perfusion parameters, Kep (area under curve (AUC) 0.994) and Vp (AUC 0.992) were found to have the highest diagnostic value. In diffusion‐weighted imaging, paragangliomas had a lower mean ADC compared to schwannomas (p < 0.001). The SUVmax and SUVmean were significantly associated with Ktrans, Kep, and Vp in paragangliomas. Conclusion DCE‐MRI in addition to DWI‐MRI can accurately distinguish HNPGL from schwannoma and may replace the need for any additional imaging and preoperative biopsy in most cases.

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Section: Discussionmentioning

confidence: 99%

Dynamic contrast‐enhanced magnetic resonance imaging for differentiating head and neck paraganglioma and schwannoma

et al. 2021

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“…A total of 55 patients with head and neck masses were evaluated by Backry et al 10 Four TIC patterns were described: Type A (gradual enhancement), type B (rapid enhancement and low washout), type C (rapid enhancement and fast washout), and type D (flat). It was found that most of the benign tumors showed type A curve while malignant tumors showed type C curve while curve B and D were statistically insignificant.…”

Section: Dce-mrimentioning

confidence: 99%

Differentiation of Benign From Malignant Sinonasal Masses Using Diffusion Weighted Imaging and Dynamic Contrast Enhanced Magnetic Resonance Imaging

Daga

Kumar

Pradhan

et al. 2021

Am J Rhinol�Allergy

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Background The sinonasal region is affected by a variety of neoplasms. A differentiation between benign and malignant masses is essential both for management and prognostication. Morphological analysis often does not allow this differentiation. Objectives This article aims to assess the value of advanced MRI (diffusion [DWI] and dynamic contrast enhanced MRI [DCE-MRI]) in differentiation of benign and malignant sinonasal masses. Methods This prospective study included 40 patients with sinonasal masses who underwent advanced MR on 3T MR scanner. The lesions were analyzed based on morphological characteristics, qualitative, quantitative diffusion parameters, and time signal intensity curves. Apparent diffusion coefficient (ADC) values were acquired using b values of 50 and 1000 s/mm2. The accuracy of DWI, DCE-MRI, and combined DWI/DCE-MRI in differentiating benign from malignant sinonasal masses were analyzed. Results Perineural extension and growth pattern of the tumor were the best morphological discriminators. Mean ADC values for benign and malignant lesions were 1.675 ± 0.561 and 0.903 ± 0.405 × 10−3 mm2/sec, ,respectively. ROC revealed that ADC cutoff value of 1.005 × 10−3 mm2/sec provided an accuracy of 92.5% in differentiating benign from malignant masses ( P value <.01). On excluding the benign vascular masses (Juvenile Nasopharyngeal Angiofibroma and hemangioma), the time signal intensity curve showed 78% accuracy ( P value <.001). The highest diagnostic performance was achieved by combining DWI and DCE-MRI (95% accuracy). Conclusion DWI has higher accuracy than DCE-MRI. Quantitative DWI is preferable over qualitative DWI. Accuracy of DCE-MRI can be increased by excluding vascular masses with characteristic imaging features. DWI and DCE-MRI have the highest accuracy when used in combination than either of them alone in differentiating benign from malignant sinonasal masses.

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“…10,12 Only one study used quantitative dynamic contrast-enhanced MRI (DCE-MRI) parameters with STA but in a small percentage of included cases (3/55, 5.5%). 13 No reports focused on only STA.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, to date only 11 cases have been reported regarding the apparent diffusion coefficient (ADC) values of STA 10,12 . Only one study used quantitative dynamic contrast‐enhanced MRI (DCE‐MRI) parameters with STA but in a small percentage of included cases (3/55, 5.5%) 13 . No reports focused on only STA.…”

Section: Introductionmentioning

confidence: 99%

MRI features of sinonasal tract angiofibroma/juvenile nasopharyngeal angiofibroma: Case series and systematic review

Baba

Kurokawa

et al. 2023

Journal of Neuroimaging

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Background and PurposeTo comprehensively summarize the radiological characteristics of sinonasal tract angiofibroma (STA) (commonly known as juvenile nasopharyngeal angiofibroma).MethodsForty‐four lesions from 41 cases provided by 33 study articles identified through a systematic review and 13 lesions from 13 cases from our institution associated with patients with STA who underwent MRI were included in the review study, carried out by two board‐certified experienced radiologists.ResultsThe study participants were all male patients with a mean age of 15.6 years at the time of diagnosis. All of them presented with nasal cavity lesions (100%), predominantly in the nasopharynx (98.2%). The sphenopalatine foramen/pterygopalatine fossa was involved in 76.0%, and compressive shift of the posterolateral wall of the maxillary sinus was present in more than half (57.9%). T2‐weighted imaging signal intensity was heterogeneous with mixed high and iso intensities as compared to skeletal muscle (100%). T1‐weighted imaging showed partial high signal intensity in 61.1% of the cases. Flow void and intense enhancement were present in almost all cases. Cystic/nonenhancement changes on contrast‐enhanced MRI were relatively common (40.8%). The mean apparent diffusion coefficient value (2.07 × 10−3 mm2/second) and some quantitative dynamic contrast‐enhanced MRI parameters were high. There was a significant difference in the frequency of residual/recurrent lesions based on the presence of MRI findings of skull base invasion (p = .017) and intracranial extension (p = .003).ConclusionsWe summarized the MRI findings of STA that can facilitate timely diagnosis and appropriate management.

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Role of dynamic contrast enhanced MR perfusion in differentiation between benign and malignant tumors

Cited by 5 publications

References 23 publications

Dynamic contrast‐enhanced magnetic resonance imaging for differentiating head and neck paraganglioma and schwannoma

Dynamic contrast‐enhanced magnetic resonance imaging for differentiating head and neck paraganglioma and schwannoma

Differentiation of Benign From Malignant Sinonasal Masses Using Diffusion Weighted Imaging and Dynamic Contrast Enhanced Magnetic Resonance Imaging

MRI features of sinonasal tract angiofibroma/juvenile nasopharyngeal angiofibroma: Case series and systematic review

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