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European Radiology
Published in: European Radiology 12/2020

01-12-2020 | Magnetic Resonance Imaging | Head and Neck

Characterization of parotid gland tumors: added value of permeability MR imaging to DWI and DCE-MRI

Authors: Hidetake Yabuuchi, Takeshi Kamitani, Koji Sagiyama, Yuzo Yamasaki, Tomoyuki Hida, Yuko Matsuura, Takuya Hino, Yuriko Murayama, Ryuji Yasumatsu, Hidetaka Yamamoto

Published in: European Radiology | Issue 12/2020

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Abstract

Objectives

To determine added value of permeability MRI in parotid tumor characterization to T2-weighted imaging (T2WI), semi-quantitative analysis of time-intensity curve (TIC), and intra-voxel incoherent motion diffusion-weighted imaging (IVIM-DWI).

Methods

This retrospective study was approved by the institutional review board, and the informed consent was waived. Sixty-one parotid tumors in 61 patients were examined using T2WI, IVIM-DWI, and permeability MRI. TIC patterns were categorized as persistent, washout, or plateau. Signal intensity ratio of lesion-to-muscle on T2WI, apparent diffusion coefficients (ADCs), D and f values from IVIM-DWI, and Ktrans, kep, Ve, and Vp values from permeability MRI were measured. Multiple comparisons were applied to determine whether any differences among 4 histopathologic types (pleomorphic adenomas, Warthin’s tumors, other benign tumors, and malignant tumors) existed. Diagnostic accuracy was compared before and after modification diagnosis referring to permeability MRI. In a validation study, 60 parotid tumors in 60 patients were examined.

Results

ADC and D values of malignant tumors were significantly lower than those of benign tumors other than Warthin’s tumors, but higher than those of Warthin’s tumors. kep and Vp values of Warthin’s tumors were significantly higher than those of malignant tumors. Multivariate analyses showed that TIC pattern, D, and kep values were suitable parameters. McNemar’s test showed a significant increase of sensitivity (11/12, 92%) and specificity (46/49, 94%) with adding kep. The validation study yielded high sensitivity (14/16, 88%) and specificity (41/44, 93%).

Conclusion

Permeability MRI offers added value to IVIM-MRI and semi-quantitative TIC analysis of DCE-MRI in characterization of parotid tumors

Key Points

• Permeability MR imaging offers added value in the characterization of parotid gland tumors in combination with semi-quantitative TIC analysis and IVIM analyses with D parameter.
• The combination of TIC pattern, D, and k ep might facilitate accurate characterization of parotid gland tumor, thereby avoiding unnecessary surgery for benign tumors or delayed treatment for malignant tumors.
• A combination of permeability and diffusion MR imaging can be used to guide the selection of an appropriate biopsy site.
Appendix
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Metadata
Title
Characterization of parotid gland tumors: added value of permeability MR imaging to DWI and DCE-MRI
Authors
Hidetake Yabuuchi
Takeshi Kamitani
Koji Sagiyama
Yuzo Yamasaki
Tomoyuki Hida
Yuko Matsuura
Takuya Hino
Yuriko Murayama
Ryuji Yasumatsu
Hidetaka Yamamoto
Publication date
01-12-2020
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-020-07004-3

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