The role of diffusion-weighted and dynamic contrast enhancement perfusion-weighted imaging in the evaluation of salivary glands neoplasms

Pietragalla, Michele; Nardi, Cosimo; Bonasera, Luigi; Mungai, Francesco; Taverna, Cecilia; Novelli, Luca; Renzis, Alioscia Giancarlo Domenico De; Calistri, Linda; Tomei, Maddalena; Occhipinti, Mariaelena; Colagrande, Stefano

doi:10.1007/s11547-020-01182-2

Cited by 19 publications

(15 citation statements)

References 40 publications

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“…The largest lesion diameter is calculated on the tumor portion that appears “vital” ( Table 1 ) [ 34 ]. The viable tumor ( Figure 1 ) can be assessed with protocols including a combination of arterial, portal venous and delayed phase, based on the tumor (e.g., should be measured during the arterial phase for hypervascular tumors and on portal phase for hypovasular tumors) [ 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ].…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review about Imaging and Histopathological Findings for Detecting and Evaluating Electroporation Based Treatments Response

Granata

Fusco

Salati

et al. 2021

IJERPH

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Background: Imaging methods and the most appropriate criteria to be used for detecting and evaluating response to oncological treatments depend on the pathology and anatomical site to be treated and on the treatment to be performed. This document provides a general overview of the main imaging and histopathological findings of electroporation-based treatments (Electrochemotherapy—ECT and Irreversible electroporation—IRE) compared to thermal approach, such as radiofrequency ablation (RFA), in deep-seated cancers with a particular attention to pancreatic and liver cancer. Methods: Numerous electronic datasets were examined: PubMed, Scopus, Web of Science and Google Scholar. The research covered the years from January 1990 to April 2021. All titles and abstracts were analyzed. The inclusion criteria were the following: studies that report imaging or histopathological findings after ablative thermal and not thermal loco-regional treatments (ECT, IRE, RFA) in deep-seated cancers including pancreatic and liver cancer and articles published in the English language. Exclusion criteria were unavailability of full text and congress abstracts or posters and different topic respect to inclusion criteria. Results: 558 potentially relevant references through electronic searches were identified. A total of 38 articles met the inclusion criteria: 20 studies report imaging findings after RFA or ECT or IRE in pancreatic and liver cancer; 17 studies report histopathological findings after RFA or ECT or IRE; 1 study reports both imaging and histopathological findings after RFA or ECT or IRE. Conclusions: Imaging features are related to the type of therapy administrated, to the timing of re-assessment post therapy and to the imaging technique being used to observe the effects. Histological findings after both ECT and IRE show that the treated area becomes necrotic and encapsulated in fibrous tissue, suggesting that the size of the treated lesion cannot be measured as an endpoint to detect response. Moreover, histology frequently reported signs of apoptosis and reduced vital tissue, implying that imaging criteria, which take into account the viability and not the size of the lesion, are more appropriate to evaluate response to treatment.

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Section: Resultsmentioning

confidence: 99%

A Systematic Review about Imaging and Histopathological Findings for Detecting and Evaluating Electroporation Based Treatments Response

Granata

Fusco

Salati

et al. 2021

IJERPH

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“…However, Warthin tumors may have confusing features, showing even higher diffusion restriction than malignant tumors and similar ITSS [54]. Low and progressive wash-in on dynamic contrastenhanced perfusion-weighted imaging (DCE-PwI) in association with high ADC values were observed only in benign neoplasms [55]. But Warthin tumors ADC values and contrast enhancement curve patterns overlapped with lymphomas and malignant tumors [55].…”

Section: Contrast-enhanced and Nuclear Medicine Techniquesmentioning

confidence: 99%

“…Low and progressive wash-in on dynamic contrastenhanced perfusion-weighted imaging (DCE-PwI) in association with high ADC values were observed only in benign neoplasms [55]. But Warthin tumors ADC values and contrast enhancement curve patterns overlapped with lymphomas and malignant tumors [55]. Recently introduced amide proton transfer-weighted (APTw) MRI can be useful in discriminating malignant from benign tumors of the major salivary glands, where APTw-signals in malignant tumors are significantly higher than in benign ones [56].…”

Section: Contrast-enhanced and Nuclear Medicine Techniquesmentioning

confidence: 99%

WFUMB position paper. Incidental findings of the salivary glands

Białek¹,

Lim

Dong

et al. 2021

Med Ultrason

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A salivary incidentaloma (SI) stands for any focal salivary lesion, independent of size, discovered by any imaging method including ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), multimodal positron emis-sion tomography (PET) combined with CT or MRI, or X-ray imaging, performed for another reason, in the absence of known salivary glands’ disease. The article presents a detailed analysis of salivary gland diseases with the emphasis on neoplasms. It describes frequency of SIs found on imaging, their prevalence, epidemiology and clinical significance. The probability of malignancy or malignant transformation of a SI, its imaging features, recommended treatment, management and follow-up, as well as ethical issues, psychological burden, informed decision making, economical consequences and costs are discussed. The general prevalence of SIs is low, but is dramatically increasing over time, and may rise significantly in selected groups of oncologic patients. SIs most frequently turn out to be benign primary neoplasms or pseudotumors, including intraparenchymal lymph nodes. SIs detected by other imaging methods should be subsequently assessed with US. Solid SIs demand ultrasound guided fine-needle aspiration cytology (US-FNAC). Neoplasms should undergo surgery. Post-operative US follow-up is man-datory for malignant tumors and recommended for benign neoplasms.

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“…However, FNAC presents limited sensitivity and a high number of non-diagnostic samples [7] while CNB, despite the diagnostic superiority [8], is still not considered the reference standard due to invasiveness, possible false negatives, and risk of tumor seeding [9]. For these reasons, many efforts are recently put into determining if multiparametric and advanced MR sequences such as diffusion-weighted imaging (DwI) and dynamic contrast-enhanced (DCE) imaging could have a role in characterizing salivary gland tumors [10][11][12][13] and differentiating benign from malignant lesions [12][13][14][15], with various results.…”

Section: Introductionmentioning

confidence: 99%

Imaging biomarkers in the diagnosis of salivary gland tumors: the value of lesion/parenchyma ratio of perfusion-MR pharmacokinetic parameters

et al. 2021

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Background and purpose Morphologic magnetic resonance imaging (MRI) for characterization of salivary gland tumors has limited utility, and the use of perfusion MRI data in the clinical setting is controversial. We examined the potential of tissue-normalized dynamic contrast-enhanced (DCE) MRI pharmacokinetic parameters of salivary gland tumors as imaging biomarkers for characterization and differentiation between benign and malignant lesions. Materials and methods DCE-MR images acquired from 60 patients with parotid and submandibular gland tumors were retrospectively reviewed. Pharmacokinetic parameters as transfer constant (Ktrans), rate constant (Kep), extracellular space volume (Ve), fractional plasma volume (Vp), and AEC (area of all times enhancement curve) were measured on both the lesion and the normal contralateral salivary gland parenchyma. Lesion/parenchyma ratio (L/P) for each parameter was calculated. Results Five groups of lesions were identified (reference: histopathology): pleomorphic adenomas(n = 20), Warthin tumors(n = 16), other benign entities(n = 4), non-Hodgkin lymphomas(n = 4), and malignancies(n = 16). Significant differences were seen for mean values of L/PKtrans (higher in malignancies), L/PKep (lower in adenomas than Warthin tumors), L/PVe (lower in Warthin tumors and lymphomas), L/PVp (higher in Warthin tumors and malignancies than adenomas), and L/PAEC (higher in malignancies). Significant differences were found between benign and malignant (non-lymphoproliferative) lesions in mean value of L/PKtrans (0.485 and 1.581), L/PVp (1.288 and 2.834), and L/PAEC (0.682 and 1.910). ROC analysis demonstrated the highest AUC (0.96) for L/PAEC, with sensitivity and specificity for malignancy of 93.8% and 97.5% (cutoff value = 1.038). Conclusion Lesion/parenchyma ratio of DCE-MRI pharmacokinetic data could be helpful for recognizing the principal types of salivary gland tumors; L/PAEC seems a valuable biomarker for differentiating benign from malignant tumors.

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The role of diffusion-weighted and dynamic contrast enhancement perfusion-weighted imaging in the evaluation of salivary glands neoplasms

Cited by 19 publications

References 40 publications

A Systematic Review about Imaging and Histopathological Findings for Detecting and Evaluating Electroporation Based Treatments Response

A Systematic Review about Imaging and Histopathological Findings for Detecting and Evaluating Electroporation Based Treatments Response

WFUMB position paper. Incidental findings of the salivary glands

Imaging biomarkers in the diagnosis of salivary gland tumors: the value of lesion/parenchyma ratio of perfusion-MR pharmacokinetic parameters

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