Parotid gland tumors: comparison of conventional and diffusion-weighted MRI findings with histopathological results

2020 ◽  
pp. 20200391
Author(s):  
Can Zafer Karaman ◽  
Ahmet Tanyeri ◽  
Recep Özgür ◽  
Veli Süha Öztürk
Keyword(s):  
Parotid Gland ◽  
Pleomorphic Adenoma ◽  
Malignant Tumors ◽  
Mri Findings ◽  
Parotid Gland Tumors ◽  
Conventional Mri ◽  
Diffusion Weighted ◽  
Pleomorphic Adenomas ◽  
Adc Values ◽  
The Mean

Objectives: The aim of this study was to investigate the relationship between pathological classification of parotid gland tumors and conventional MRI – diffusion-weighted imaging findings and also contribute the possible effect of apparent diffusion coefficient (ADC) to diagnosis. Methods: 60 patients with parotid masses diagnosed using histopathology and/or cytology were enrolled in this retrospective study. All patients were evaluated using a 1.5 T MRI. Demographic features, conventional MRI findings, and ADC values (mean, minimum, maximum, and relative) were recorded. MRI findings and ADC values were compared between benign–malignant groups and pleomorphic adenoma vs Warthin’s tumor groups. Results: 60 tumors (48 benign, 12 malignant) were evaluated in a total of 60 patients (39 males, 21 females). The mean age was 59 (±14, 18–86) years old; the mean lesion size was 26 (±10, 11–61) mm. On the texture of conventional MRI, T2 dominantly hyperintense/with hypointensity signal was seen in 87% of pleomorphic adenomas and T2 dominantly hypointense/with hyperintesity signal was encountered in 64% of all Warthin’s tumors. Seven (28%) Warthin’s tumors were misdiagnosed as pleomorphic adenomas and two others (8%) as malignant tumors. The commonly used mean ADC value was 1.6 ± 0.6 × 10–3 mm2 s−1 for benign tumors, 0.8 ± 0.3 × 10–3 mm2 s−1 for malign tumors, 1 (0.9–1.8) × 10–3 mm2 s−1 for Warthin’s tumors, and 1.9 ± 0.3 × 10–3 mm2 s−1 for pleomorphic adenomas. There was a statistically significant difference in ADC values between benign-malignant tumors and pleomorphic adenomas-Warthin’s tumors. Conclusions: Warthin’s tumor may occasionally be misdiagnosed as pleomorphic adenoma and malignant tumor because of variable morphologic features. In addition to benign–malignant differentiation, the added ADC measurement may also be useful for differentiating Warthin’s tumors from pleomorphic adenomas.

scholarly journals Differentiation of Benign and Malignant Parotid Gland Tumors with MRI and Diffusion Weighted Imaging

2021 ◽  
Author(s):  
Umut Perçem Orhan Söylemez ◽  
Başak Atalay
Keyword(s):  
Parotid Gland ◽  
Signal Intensity ◽  
Perineural Spread ◽  
Adc Value ◽  
Parotid Gland Tumors ◽  
Superficial Lobe ◽  
Adjacent Structures ◽  
Significant Difference ◽  
Pleomorphic Adenomas ◽  
Adc Values

Objective: This study investigated the effectivity of Magnetic Resonance Imaging (MRI) findings and Apparent Diffusion Coefficient (ADC) value in evaluating parotid gland tumors (PGTs), and aimed to reduce the biopsy procedure before surgery. Methods: This retrospective study included 54 PGTs of 42 patients’ (24 female, 18 male, mean age; 51.4±15.9). All of the patients had an MRI, and histopathologic diagnosis. The signal intensity [T1 and T2 Weighted (W), T1W after intravenous contrast agent injection] and mean ADC values of the PGTs were measured. Also contrast enhancement pattern (homogenous, heterogeneous, peripheral or none), margin features (well or ill-defined), sizes, location (superficial lobe/deeplobe/both), perineural spread, presence of lymphadenopathy, and extension to adjacent structures were noted. Results: The distribution of PGTs was; 21 pleomorphic adenomas, 18 Warthin tumors, 2 lymph nodes, 2 mucoepidermoid carcinomas, 5 adenoid cystic carcinoma, 1 basal cell carcinoma,2 metastases and 2 lymphomas; (13 malignant and 41 benign lesions). Morphologic parameters; ill-defined margin, perineural spread, lymphadenopathy, and extension to adjacent structures were found to be significantly associated with malign lesions (p<0.01). There was a significant difference between ADC values of malignant and benign PGTs (p<0.05). Also ADC values and T2 signal intensity was significantly lower in Warthin tumors rather than pleomorphic adenomas (p<0.05). Conclusions: Mean ADC values when considered with morphological features may be accessible methods to distinguish benign and malignant PGTs, also ADC values and T2 signal intensity may be useful for differentiating pleomorphic adenomas from Warthin tumors, thereby reducing the number of biopsies and thus complications.

scholarly journals Diffusion-weighted Magnetic Resonance Imaging in the Diagnosis of Bone Tumors: Preliminary Results

2013 ◽  
Vol 3 ◽  
pp. 63 ◽  
Author(s):  
Yeliz Pekcevik ◽  
Mehmet Onur Kahya ◽  
Ahmet Kaya
Keyword(s):  
Magnetic Resonance ◽  
Bone Tumors ◽  
Malignant Tumors ◽  
Receiver Operating Curve ◽  
Benign Tumors ◽  
Single Shot ◽  
Malignant Bone Tumors ◽  
Diffusion Weighted ◽  
Adc Values ◽  
The Mean

Objective: The study aims to determine whether apparent diffusion coefficient (ADC) can help differentiate benign and malignant bone tumors. Materials and Methods: From January 2012 to February 2013, we prospectively included 26 patients. Of these 15 patients were male and 11 were female; ranging in age from 8 to 76 years (mean age, 34.5 years). Diffusion-weighted magnetic resonance (MR) imaging was obtained with a single-shot echo-planar imaging sequence using a 1.5T MR scanner. We grouped malignant lesions as primary, secondary, and primary tumor with chondroid matrix. The minimum ADC was measured in the tumors and mean minimum ADC values were selected for statistical analysis. ADC values were compared between malignant and benign tumors using the Mann-Whitney U-test and receiver operating curve analysis were done to determine optimal cut-off values. Results: The mean ADC values from the area with lowest ADC values of benign and malignant tumors were 1.99 ± 0.57 × 10−3 mm2/s and 1.02 ± 1.0 × 10−3 mm2/s, respectively. The mean minimum ADC values of benign and malignant tumors were statistically different (P = 0.029). With cut-off value of 1.37 (10−3 mm2/s), sensitivity was 77.8% and specificity was 82.4%, for distinguishing benign and malignant lesion. Benign and secondary malignant tumors showed statistically significant difference (P = 0.002). There was some overlap in ADC values between benign and malignant tumors. The mean minimum ADC values of benign and malignant chondroid tumors were high. Giant cell tumor, non-ossifying fibroma and fibrous dysplasia showed lower ADC values. Conclusion: Although there is some overlap, ADC values of benign and malignant bone tumors seem to be different. Further studies with larger patient groups are needed to find an optimal cut-off ADC value.

Characterization of parotid gland tumors using T2 mapping imaging: initial findings

2019 ◽  
Vol 61 (5) ◽  
pp. 629-635 ◽  
Author(s):  
Qian Wu ◽  
Liu-Ning Zhu ◽  
Jia-Suo Jiang ◽  
Shou-Shan Bu ◽  
Xiao-Quan Xu ◽  
...  
Keyword(s):  
Parotid Gland ◽  
Malignant Tumors ◽  
T2 Mapping ◽  
Relaxation Times ◽  
Threshold Value ◽  
T2 Relaxation ◽  
Parotid Gland Tumors ◽  
Pleomorphic Adenomas ◽  
Malignant Group

Background Preoperative accurate characterization of parotid gland tumors in different histologic types is crucial. T2 mapping has been proven to be useful for improving the accuracy of tumor characterization. Purpose To evaluate the ability of T2 mapping imaging in the characterization of parotid gland tumors. Material and Methods T2 mapping imaging was scanned in 74 patients (56 benign, 18 malignant) with pathologically confirmed parotid gland tumors. Mean T2 relaxation time was calculated and compared between benign and malignant group, and among malignant tumors, Warthin’s tumors, and pleomorphic adenomas. Independent-samples t test, one-way analysis of variance test, and receiver operating characteristic curve analyses were used for statistical analyses. Results The malignant group showed significantly lower T2 relaxation times than the benign group ( P = 0.001). Using a relaxation time of 91.5 ms as the cut-off value, optimal diagnostic performance could be achieved (area under the curve [AUC] 0.679, sensitivity 46.4%, specificity 94.4%). Pleomorphic adenomas showed significantly higher T2 relaxation times than malignant tumors ( P = 0.003) and Warthin’s tumors ( P = 0.001). However, no significant difference was found on the T2 relaxation times between Warthin’s tumors and malignant tumors ( P = 0.435). Optimal diagnostic performance could be achieved (AUC 0.783, sensitivity 58.1%, specificity 94.4%), when setting a T2 value of 92.0 ms as the threshold value for differentiating pleomorphic adenomas from malignant tumors. Meanwhile, optimal AUC, sensitivity, and specificity were 0.892, 87.1%, and 83.3%, respectively, when setting a T2 value of 80.5 ms as the threshold value for differentiating pleomorphic adenomas from Warthin’s tumors. Conclusion T2 mapping imaging could serve as an incremental imaging biomarker for characterizing parotid gland tumors.

scholarly journals Can Magnetic Resonance Radiomics Analysis Discriminate Parotid Gland Tumors? A Pilot Study

Diagnostics ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 900
Author(s):  
Michela Gabelloni ◽  
Lorenzo Faggioni ◽  
Simona Attanasio ◽  
Vanina Vani ◽  
Antonio Goddi ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Parotid Gland ◽  
Diagnostic Accuracy ◽  
Pleomorphic Adenoma ◽  
Roc Curve ◽  
Malignant Tumors ◽  
Support Vector ◽  
Benign Tumors ◽  
Pleomorphic Adenomas ◽  
Sensitivity Specificity

Our purpose is to evaluate the performance of magnetic resonance (MR) radiomics analysis for differentiating between malignant and benign parotid neoplasms and, among the latter, between pleomorphic adenomas and Warthin tumors. We retrospectively evaluated 75 T2-weighted images of parotid gland lesions, of which 61 were benign tumors (32 pleomorphic adenomas, 23 Warthin tumors and 6 oncocytomas) and 14 were malignant tumors. A receiver operating characteristics (ROC) curve analysis was performed to find the threshold values for the most discriminative features and determine their sensitivity, specificity and area under the ROC curve (AUROC). The most discriminative features were used to train a support vector machine classifier. The best classification performance was obtained by comparing a pleomorphic adenoma with a Warthin tumor (yielding sensitivity, specificity and a diagnostic accuracy as high as 0.8695, 0.9062 and 0.8909, respectively) and a pleomorphic adenoma with malignant tumors (sensitivity, specificity and a diagnostic accuracy of 0.6666, 0.8709 and 0.8043, respectively). Radiomics analysis of parotid tumors on conventional T2-weighted MR images allows the discrimination of pleomorphic adenomas from Warthin tumors and malignant tumors with a high sensitivity, specificity and diagnostic accuracy.

ROLE OF DIFFUSION WEIGHTED MRI IN ASSESSMENT OF BENIGN AND MALIGNANT HEPATIC FOCAL LESIONS IN ADULT AGE GROUP

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hanan Mohammed Hanafy ◽  
Ayman Mohammed Ibrahim ◽  
Haytham Mohamed Nasser ◽  
Moataz Metwally Elsayed
Keyword(s):  
Focal Lesions ◽  
Adc Value ◽  
Adult Age ◽  
Conventional Mri ◽  
Diffusion Weighted ◽  
Adc Values ◽  
Weighted Magnetic Resonance Imaging ◽  
Mri Sequences ◽  
Value Measurement

Abstract Purpose of this study is: To evaluate the role of diffusion weighted magnetic resonance imaging in differentiation between malignant & benign hepatic focal lesions. Methods The study included 38 patients all of them were with hepatic focal lesions detected by ultrasound (between 20 and 85 years of age) referred from GIT and oncology departments. Each patient included in the study was subjected to full history taking, ultrasonography and conventional MRI sequences, post Gd- DTPA dynamic and Diffusion Weighted imaging as well as ADC value measurement. Technique was performed using a standard 1.5 Tesla unit (Ingenia, Philips). Detailed MRI and laboratory investigations were done. Results The study showed significant results were obtained between ADC values of benign and malignant hepatic focal lesions (p &lt; 0.001). Conclusion We concluded in this study according to the obtained results that DWI sequence together with quantitative ADC values should be used as an essential sequence to supplement the conventional MRI sequences for proper detection and characterization of hepatic focal lesions.

Surgical treatment of benign parotid gland tumors in the years 2014–2018 at the ENT department of Hospital České Budějovice, a.s.

2021 ◽  
Vol 70 (2) ◽  
pp. 82-88
Author(s):  
Hana Zapletalová ◽  
Martin Kuchař ◽  
Lubor Mrzena
Keyword(s):  
Surgical Treatment ◽  
Parotid Gland ◽  
Facial Nerve ◽  
Pleomorphic Adenoma ◽  
Benign Tumors ◽  
Histological Structure ◽  
Warthin’S Tumor ◽  
Parotid Gland Tumors ◽  
Warthin's Tumor ◽  
Keywords Parotid Gland

ntroduction: Salivary tumors represent a heterogeneous group of tumors of diverse location, histological structure and bio logical behavior. The purpose of this study was a retrospective evaluation of surgical treatment of a group of patients with newly dia gnosed benign tumors of the parotid salivary gland operated in the years 2014–2018 at the ENT department of Hospital České Budějovice, a.s. Material and methods: A type of surgery, defi nitive histology, postoperative complications and a number of recurrences were monitored. The data were evaluated by descriptive statistical methods. Results: A total of 190 surgeries with benign histological fi ndings in 182 patients were performed. The most common benign result was Warthin‘s tumor (90 cases, 47.4%), followed by pleomorphic adenoma (66 cases, 34.7%). Uncommon histological types of tumors were dia gnosed in 14 patients (7.4%). Non-tumorous fi ndings were found in 20 cases (10.5%). The most frequently performed procedure in 84 cases (44.2%) was extracapsular extirpation. Transient lesion in the area of innervation of the temporofacial and / or cervicofacial branch of the facial nerve was present in 34 (17.9%) patients. Permanent paresis of some of the branches of the facial nerve was reported in 2 (1.1%) patients. In 12 patients, the postoperative course was complicated by the development of salivary fi stula (6.3%). Pleomorphic adenoma relapsed after extracapsular extirpation in 5 cases (20.0%). After partial parotidectomy, one recurrence of pleomorphic adenoma (3.6%) was recorded. Warthin‘s tumor relapsed after simple extirpation in 4 cases (20.0%). Conclusion: Our evaluation results of the surgical treatment of benign parotid gland tumors lead us to make further eff orts improve the care of our patients. We see reserves mainly in the routine use of ultrasonographic examination with performance FNAC and thus planning a safe and suffi ciently radical operational solution. Keywords: parotid gland – pleomorphic adenoma – Warthin‘s tumor – parotidectomy – recurrence – facial nerve paresis – FNAC

Clinical suspicion of spondylodiscitis with equivocal MRI findings: does diffusion-weighted imaging prove helpful here?

2020 ◽  
pp. 028418512092790
Author(s):  
Jeanette Henkelmann ◽  
Kristina Bremicker ◽  
Timm Denecke ◽  
Karl-Titus Hoffmann ◽  
Ralf Henkelmann ◽  
...  
Keyword(s):  
Diffusion Weighted Imaging ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Region Of Interest ◽  
High Sensitivity ◽  
Diagnostic Value ◽  
Mri Findings ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Adc Values

Background Despite the high sensitivity of magnetic resonance imaging (MRI), early detection of spondylodiscitis (SpD) remains challenging due to its low specificity. Purpose To assess the diagnostic value of diffusion-weighted imaging (DWI) in suspected cases of SpD with ambiguous early MRI findings in the differentiation of degenerative disorders (DD). Material and Methods In this prospective study, 52 patients suspected of having SpD underwent a whole-spine 3-T MRI scan comprising sagittal DWI. Of 58 conspicuous, T2-weighted, signal increased discs, 39 were successfully evaluated using DWI. Apparent diffusion coefficient (ADC) values and ADC maps were blindly analyzed using the region of interest of the conspicuous disc and a normal adjacent reference disc. Intraindividual ratios (conspicuous disc: reference disc) were calculated. Results All conspicuous discs showed increased absolute ADC values, which did not differ significantly between SpD (n = 22) and DD (n = 17). However, ADC ratio was significantly higher in SpD vs. DD ( P < 0.05). In receiver operating characteristic curve analysis, an ADC ratio threshold of 1.6 resulted in 45% sensitivity and 88% specificity (area under the curve = 0.69) for SpD diagnosis. Conclusion The absolute ADC value does not provide a reliable diagnosis of SpD. Increased diffusivity can be an indication of infection but should always be discussed in the context of existing disc degeneration.

scholarly journals Differentiating Benign from Malignant Sinonasal Lesions: Feasibility of Diffusion Weighted MRI

2017 ◽  
Vol 21 (04) ◽  
pp. 358-365 ◽  
Author(s):  
Khaled El-Gerby ◽  
Mohammad El-Anwar
Keyword(s):  
Predictive Value ◽  
Quantitative Methods ◽  
Malignant Tumors ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Tumor Tissues ◽  
Apparent Diffusion ◽  
Diagnostic Role ◽  
Adc Values ◽  
Histopathological Results

Introduction Appearance of nasal masses on routine CT and MRI are not pathognomonic. We utilized the apparent diffusion coefficient (ADC) value obtained from diffusion weighted image (DWI) to detect the differences in the microstructures of tumor and non-tumor tissues. Objective The objective of our study was to evaluate the diagnostic role of DWI and ADC values in differentiating between malignant and benign sinonasal lesions and its correlation with histopathological results as the reference standard. Methods Patients with nasal and / or paranasal mass underwent CT, MRI, and DWI before any surgical intervention. We used diagnostic sinonasal endoscopy and biopsy to confirm the diagnosis after MRI. Results When we used ADC value of (1.2 × 10–3 mm2/s) as a cut-off value for differentiating benign from malignant sinonasal lesions, we achieved 90% accuracy, 100% sensitivity, 88.4% specificity, 77.8% positive predictive value, and 100% negative predictive value. At this cut-off, benign lesions show statistically significant higher ADC value than malignant tumors. Conclusion DW MRI and ADC value calculation are promising quantitative methods helping to differentiate between malignant and benign sinonasal lesions. Thus, they are effective methods compared with other conventional methods with short imaging time thus it is recommended to be incorporated into routine evaluations.

Diffusion-weighted imaging using ADC mapping as an imaging biomarker for breast cancer invasiveness.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 11093-11093
Author(s):  
Hubert Bickel ◽  
Wolfgang Bogner ◽  
Peter Christian Dubsky ◽  
Rupert Bartsch ◽  
Margaretha Rudas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Diffusion Weighted Imaging ◽  
Malignant Tumors ◽  
Imaging Biomarker ◽  
Benign Tumors ◽  
Non Invasive ◽  
Diffusion Weighted ◽  
Cancer Invasiveness ◽  
Adc Values ◽  
Breast Cancer Invasiveness

11093 Background: Recently, functional imaging techniques such as diffusion weighted imaging (DWI) have been added to routine MR and have shown great potential for improving breast cancer diagnosis. DWI depicts cellular diffusivity on a molecular level and can be quantified using the apparent diffusion coefficient (ADC). In malignant tumors diffusivity is restricted, leading to lower ADC values than benign tumors. The aim of this study was to proof, that DWI can be used to differentiate benign from malignant tumors and to elucidate if ADC can serve as an imaging biomarker for breast cancer invasiveness. Methods: In this IRB-approved study 250 patients with 267 suspicious breast lesions (BI-RADS IV-V) were included. All patients underwent routine MR at 3T. A DWI-sequence was added to a standard imaging protocol, increasing measurement time by 2:30 min. The lesions were identified in routine MR and DWI sequences and ADC values of the lesions were calculated. Histopathology was used as the standard of reference for all lesions. Appropriate statistical tests were used to compare the ADC values of benign and malignant tumors (cut-off value 1.25×10-3mm²/s), of invasive and non-invasive disease and between different invasive tumor subtypes. Results: There were 91 benign (mean ADC 1.58×10-3mm²/s) and 176 malignant (.94×10-3mm²/s) lesions, sensitivity and specificity were 94.3% (PPV 95.4%, CI 0.91-0.98) and 91.2% (NPV 89.2%, CI 0.81-0.94). 155 lesions were invasive cancers (median ADC .90×10-3mm²/s), while 21 were non-invasive ductal carcinoma in situ (1.22×10-3mm²/s). The invasive cancers were 130 invasive ductal (median ADC .91×10-3mm²/s) and 25 invasive lobular cancers (.83×10-3mm²/s). ADC was significantly different between benign and malignant lesions (p<.001) and between invasive and non-invasive cancers (p<.001), while no significant difference could be found between the invasive cancer subtypes (p=.163). Conclusions: Diffusion-weighted imaging reliably allows differentiation of benign and malignant breast tumors. The data suggest that ADC can be used as a non-invasive imaging biomarker for breast cancer invasiveness and may be of importance to treatment planning and outcome in breast cancer patients.

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