Abstract
Objective
To assess the usefulness of combined diffusion kurtosis imaging (DKI) and dynamic contrast-enhanced MRI (DCE-MRI) in the differentiation of parotid gland tumors.
Methods
Seventy patients with 80 parotid gland tumors who underwent DKI and DCE-MRI were retrospectively enrolled and divided into four groups: pleomorphic adenomas (PAs), Warthin tumors (WTs), other benign tumors (OBTs), and malignant tumors (MTs). DCE-MRI and DKI quantitative parameters were measured. The Kruskal–Wallis H test and post hoc test with Bonferroni correction and ROC curve were used for statistical analysis.
Results
WTs demonstrated the highest Kep value (median 1.89, interquartile range [1.46–2.31] min−1) but lowest Ve value (0.20, [0.15–0.25]) compared with PAs (Kep, 0.34 [0.21–0.55] min−1; Ve, 0.36 [0.24–0.43]), OBTs (Kep, 1.22 [0.27–1.67] min−1; Ve, 0.28 [0.25–0.41]), and MTs (Kep, 0.71 [0.50–1.23] min−1; Ve, 0.35 [0.26–0.45]) (all p < .05). MTs had the lower D value (1.10, [0.88–1.29] × 10−3 mm2/s) compared with PAs (1.81, [1.60–2.20] × 10−3 mm2/s) and OBTs (1.57, [1.32–1.89] × 10−3 mm2/s) (both p < .05). PAs had the lower Ktrans value (0.12, [0.07–0.18] min−1) compared with OBTs (0.28, [0.11–0.50] min−1) (p < .05). The cutoff values of combined Kep and Ve, D, and Ktrans to distinguish WTs, MTs, and PAs sequentially were 1.06 min−1, 0.28, 1.46 × 10−3 mm2/s, and 0.21 min−1, respectively (accuracy, 89% [71/80], 91% [73/80], 78% [62/80], respectively).
Conclusion
The combined use of DKI and DCE-MRI may help differentiate parotid gland tumors.
Key Points
• The combined use of DKI and DCE-MRI could facilitate the understanding of the pathophysiological characteristics of parotid gland tumors.
• A stepwise diagnostic diagram based on the combined use of DCE-MRI parameters and the diffusion coefficient is helpful for accurate preoperative diagnosis in parotid gland tumors and may further facilitate the clinical management of patients.
Distinguishing benign and malignant breast tumors: preliminary comparison of kinetic modeling approaches using multi-institutional dynamic contrast-enhanced MRI data from the International Breast MR Consortium 6883 trial