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.

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 RETRACTED ARTICLE: The diagnostic value of combined dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging (DWI) in characterization of parotid gland tumors

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Mohamed Ali EL-Adalany ◽  
Amany Ezzat Mohamed Mousa ◽  
Dina EL-Metwally
Keyword(s):  
Parotid Gland ◽  
Diagnostic Value ◽  
Adc Value ◽  
Dce Mri ◽  
Parotid Gland Tumors ◽  
Contrast Enhanced ◽  
Combined Use ◽  
Significant Difference ◽  
And Diffusion

Abstract Background MRI is considered to be the imaging modality of choice in preoperative diagnosis of parotid gland tumors and differentiating benign from malignant ones. Recently, functional MR imaging sequences including dynamic contrast-enhanced magnetic resonance imaging (DCE- MRI) and diffusion-weighted imaging (DWI) have significantly contributed to the diagnosis of head and neck masses. The purpose of this study was to evaluate the diagnostic value of combined DCE-MRI and DWI in characterization of parotid gland tumors. Results There was significant difference between benign and malignant parotid gland tumors as regard the type of time intensity curve (TIC) (P < 0.001). There was significant difference between pleomorphic adenoma (PMA) and malignant parotid gland tumors (MT) as regard mean ADC value (P = 0.046) and TTP (P = 0.002). There was no significant difference between Warthin’s tumor (WT) and malignant parotid gland tumors as regard the ADC value and TTP (P > 0.5); on the other hand, WT usually have high WR when compared with MT (P = 0.004). Combined use of DCE-MRI and DWI had 100% sensitivity, 90.5% specificity, and 93.3% accuracy in differentiating benign from malignant parotid gland tumors. Conclusion Combined use of DCE-MRI and DWI could result in high sensitivity, specificity, and diagnostic accuracy in characterization of parotid gland tumors.

scholarly journals Role of Quantitative Diffusion-Weighted Imaging in Differentiating Benign and Malignant Orbital Masses

2021 ◽  
Author(s):  
Preeti Mundhada ◽  
Sudarshan Rawat ◽  
Ullas Acharya ◽  
Dhananjay Raje
Keyword(s):  
Roc Curve ◽  
Diffusion Weighted Imaging ◽  
Care Hospital ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Significant Difference ◽  
Orbital Masses ◽  
Adc Values ◽  
Orbital Lesions

Abstract Aim To determine the role of diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) values in differentiating benign and malignant orbital masses. Materials and Methods After obtaining institutional ethical board approval and informed consent from all patients, an observational study was done for a period of 24 months in the radiology department of a tertiary care hospital in South India. Conventional magnetic resonance imaging and DWI using a 3T scanner was done for all patients with suspected orbital mass lesion. ADC value and clinicohistopathological correlation were studied for every patient. Chi-square test was used to compare the signal characteristics of DWI and ADC maps between benign and malignant lesions. A comparison of mean ADC values for benign and malignant masses was performed using Student’s t-test for independent samples. The cut-off value for ADC was obtained using the receiver operating characteristic (ROC) curve. Results Of 44 patients with orbital lesions, 70% were benign and 30% were malignant. There was a significant difference in the mean ADC values of benign and malignant orbital masses. Using ROC curve analysis, an optimal ADC threshold of 1.26 × 10−3 mm2/s was calculated for the prediction of malignancy with 100% sensitivity, 80.65% specificity, and 86.36% accuracy (95% confidence interval: 0.872, 1.00, p < 0.0001). Two ADC thresholds were used to characterize the orbital masses with more than 90% confidence. Conclusion Quantitative assessment of ADC is a useful noninvasive diagnostic tool for differentiating benign and malignant orbital masses. Malignant orbital lesions demonstrate significantly lower ADC values as compared with benign lesions.

A histological comparison of deep and superficial lobe pleomorphic adenomas of the parotid gland

Head & Neck ◽  
2003 ◽  
Vol 25 (8) ◽  
pp. 649-653 ◽  
Author(s):  
Michael S. Harney ◽  
Colette Murphy ◽  
Stephen Hone ◽  
Mary Toner ◽  
Conrad V. Timon
Keyword(s):  
Parotid Gland ◽  
Superficial Lobe ◽  
Pleomorphic Adenomas

MRI findings and demographics of elastofibroma dorsi: assessment of diffusion-weighted imaging and contrast enhancement patterns

2017 ◽  
Vol 59 (6) ◽  
pp. 709-715 ◽  
Author(s):  
Maho Tsubakimoto ◽  
Tsuneo Yamashiro ◽  
Nanae Tsuchiya ◽  
Masahiro Okada ◽  
Hiroki Maehara ◽  
...  
Keyword(s):  
Contrast Enhancement ◽  
Signal Intensity ◽  
Diffusion Weighted Imaging ◽  
Enhancement Pattern ◽  
Mri Findings ◽  
Adc Value ◽  
Diffusion Restriction ◽  
Diffusion Weighted ◽  
Elastofibroma Dorsi ◽  
Significant Difference

Background Elastofibroma dorsi is a rare pseudotumoral lesion. Thus, there is no report of magnetic resonance imaging (MRI) findings that investigates multiple patients particularly with respect to diffusion-weighted imaging (DWI) findings and contrast enhancement patterns. Purpose To describe the imaging findings of elastofibroma on MRI, particularly DWI findings and contrast enhancement patterns, and to further investigate patient demographics. Material and Methods Forty-four patients with elastofibroma that underwent MRI were enrolled in this retrospective study. All images were evaluated by two radiologists to visually assess the signal intensity for each sequence. Enhanced elastofibromas were classified into four categories to assess the enhancement pattern. Differences in gender and laterality were also assessed statistically. Results An equal number of men and women were included (n = 22 each). There was no significant difference in laterality ( P = 0.783). All lesions (73 lesions) had low signal intensity on both T1-weighted (T1W) and T2-weighted (T2W) images: heterogeneous in 56, homogeneous in 17. None of the 41 lesions with DWI had true abnormal diffusion restriction. The average ADC value was 1.36 × 10–3 ± 0.29 mm2/s. All 31 lesions that had contrast-enhanced MRI were classified according to enhancement pattern: homogeneous (three lesions, 9.7%); heterogeneous (15 lesions, 48.4%); streak-like (three lesions, 9.7%); and rim-like (ten lesions, 32.2%). Conclusion There were no statistically significant differences in gender or laterality. Elastofibroma showed homogeneous to heterogeneous low signal intensity on T1W and T2W images. No lesion showed abnormal diffusion restriction, and all lesions demonstrated enhancement on MRI.

scholarly journals Feasibility study of using simultaneous multi-slice RESOLVE diffusion weighted imaging to assess parotid gland tumors: comparison with conventional RESOLVE diffusion weighted imaging

2020 ◽  
Author(s):  
Jia-Suo Jiang ◽  
Liu-Ning Zhu ◽  
Qian Wu ◽  
Yi Sun ◽  
Wei Liu ◽  
...  
Keyword(s):  
Image Quality ◽  
Parotid Gland ◽  
Diffusion Weighted Imaging ◽  
Signal To Noise Ratio ◽  
Anatomical Structure ◽  
Parotid Gland Tumors ◽  
Diffusion Weighted ◽  
Scan Time ◽  
Significant Difference ◽  
Noise Ratio

Abstract Background To evaluate the feasibility of using simultaneous multi-slice (SMS) readout segmentation of long variable echo-trains (RESOLVE) diffusion-weighted imaging (DWI) to assess parotid gland tumors, compared with conventional RESOLVE DWI Methods From September 2018 to December 2018, 20 consecutive patients with parotid tumors who underwent MRI scan for pre-surgery evaluation were enrolled. SMS-RESOLVE DWI and conventional RESOLVE DWI were scanned with matched imaging parameters, respectively. The scan time of two DWI sequences was recorded. Qualitative (anatomical structure differentiation, lesion display, artifact, and overall image quality) and quantitative (apparent diffusion coefficient, ADC; ratio of signal-to-noise ratio, SNR ratio; ratio of contrast-to-noise ratio, CNR ratio) assessments of image quality were performed, and compared between SMS-RESOLVE DWI and conventional RESOLVE DWI. Paired t-test was used for statistical analyses. Results The scan time was 3 minutes and 41 seconds for SMS-RESOLVE DWI, and 5 minutes and 46 seconds for conventional RESOLVE DWI. SMS-RESOLVE DWI produced similar qualitative image quality with RESOLVE DWI (anatomical structure differentiation, P = 0.164; lesion display, P = 0.193; artifact, P = 0.330; overall image quality, P = 0.083). Meanwhile, there were no significant difference on ADCLesion (P = 0.298), ADCMasseter (P = 0.122), SNR ratio (P = 0.584) and CNR ratio (P = 0.217) between two DWI sequences. Conclusion Compared with conventional RESOLVE DWI, SMS-RESOLVE DWI could provide comparable image quality using markedly reduced scan time. SMS could increase the clinical usability of RESOLVE technique for DWI of parotid gland.

scholarly journals Evaluation of apparent diffusion coefficient in endometrial carcinoma compared to normal endometrium: a retrospective study

2021 ◽  
Author(s):  
Anu Sarah Easo ◽  
Rajeev Anand ◽  
Mini Issac
Keyword(s):  
Diffusion Coefficient ◽  
Endometrial Cancer ◽  
Retrospective Study ◽  
Apparent Diffusion Coefficient ◽  
Normal Endometrium ◽  
Adc Value ◽  
Significant Difference ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Endometrial Cancers

Background: To determine whether diffusion-weighted imaging (DWI) with measurement of apparent diffusion coefficient (ADC) will help in differentiating endometrial cancer from normal endometrium and to determine whether the grades of endometrial cancer will show significant difference in ADC values.Methods: This is a retrospective study done in MOSC medical college hospital Kolencherry. on patients on whom preoperative MRI was done before hysterectomy. Cases from July 2017 to March 2021 were included. Study cases included 40 females with pathologically confirmed endometrial cancer and 30 females with pathologically proven normal endometrium in cases of uterine leiomyoma and cervical cancer. The exclusion criteria for the study were patients with endometrial cancer in whom surgery was not done within 2 weeks of MRI, patients who were treated with chemotherapy or radiotherapy before surgery, patients who had hydrometra or pyometra.Results: The mean ADC value (10−3 mm2/second) of endometrial cancer was 0.77±0.04, which was significantly lower (p<0.05) than that of normal endometrium (1.323±0.05). The ADC values of different grades of endometrial cancers did not show any statistically significant difference (p>0.05).Conclusions: Our study showed that ADC measurement can differentiate between normal endometrium and endometrial cancer. The ADC values of different grades of endometrial cancers did not show any statistically significant difference.  

scholarly journals Etiology and familial inheritance of pleomorphic adenomas

2017 ◽  
Vol 5 (1) ◽  
Author(s):  
Krysten Clark
Keyword(s):  
Salivary Gland ◽  
Parotid Gland ◽  
Pleomorphic Adenoma ◽  
White Male ◽  
Salivary Gland Tumor ◽  
Major Salivary Gland ◽  
Gland Tumor ◽  
Superficial Lobe ◽  
Increased Risk ◽  
Pleomorphic Adenomas

Background: A pleomorphic adenoma is the most common salivary gland neoplasm in both children and adults. Pleomorphic adenomas are derived from ductal and myoepithelial cells and are most commonly found in the superficial lobe of the parotid gland. The purpose of this article is to discuss the genes involved in pleomorphic adenomas and the possible autosomal dominant mode of inheritance. Case Description: The first patient was a white male who was diagnosed with carcinoma ex pleomorphic adenoma, a highly aggressive tumor, at the age of 57. He had an undiagnosed pleomorphic adenoma for approximately 15 years prior. The tumor was excised and the patient underwent radiation in the location of his parotid gland for 4 years until he deceased. The second patient is a white female, his daughter, who was diagnosed with a benign pleomorphic adenoma at the age of 46. Her salivary gland tumor was excised and normal follow up appointments occurred. Practical Implications: Pleomorphic adenomas most commonly affect the parotid gland, the largest of the three major salivary gland tumors. Occurrence and excision of this salivary gland tumor will cause a decrease in the secretion of saliva, leading to a dry mouth and an increased risk of caries.

scholarly journals Apparent diffusion coefficient (ADC) histogram analysis: differentiation of benign from malignant parotid gland tumors using readout-segmented diffusion-weighted imaging

2019 ◽  
Vol 48 (7) ◽  
pp. 20190100 ◽  
Author(s):  
Zanxia Zhang ◽  
Chengru Song ◽  
Yong Zhang ◽  
Baohong Wen ◽  
Jinxia Zhu ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
Parotid Gland ◽  
Apparent Diffusion Coefficient ◽  
Diffusion Weighted Imaging ◽  
Operating Characteristic ◽  
Histogram Analysis ◽  
Diagnostic Efficiency ◽  
Parotid Gland Tumors ◽  
Pleomorphic Adenomas ◽  
Apparent Diffusion

Objectives To explore the utility of whole-lesion apparent diffusion coefficient (ADC) histogram analysis for differentiating parotid gland tumors following readout-segmented diffusion-weighted imaging (RESOLVE). Methods 80 patients (40 with pleomorphic adenomas, 14 with Warthin tumors, and 26 with malignant parotid gland tumors) who underwent routine head-and-neck MRI and RESOLVE examinations, were retrospectively evaluated. RESOLVE data were acquired from a MAGNETOM Skyra 3T MR system. Eleven whole-lesion histogram parameters derived from histogram analysis (ADC_mean, ADC_minimum, ADC_maximum, ADC_1th, ADC_10th, ADC_50th, ADC_90th, ADC_99th, skewness, variance and kurtosis) were calculated for each patient using MaZda. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic performance of the ADC for distinguishing among the three groups. Results In total, nine parameters (ADC_minimum, ADC_maximum, ADC_mean, ADC_10th, ADC_50th, ADC_90th, ADC_99th, variance, skewness) were statistically significant (all p < 0.05) for all three groups, in the comparison of pleomorphic adenomas to Warthin tumors; the ADC_mean, ADC_50th, and skewness revealed high diagnostic efficiency with areas under the receiver operating characteristic curve of 0.976, 0.970, and 0.970, respectively. In the comparison of pleomorphic adenomas to malignant parotid gland tumors, these nine parameters were also found to be statistically different (all p < 0.05); the ADC_mean, ADC_10th and ADC_50th revealed high diagnostic efficiency with area under the curve of 0.851, 0.866, and 0.841, respectively. However, in the comparison of Warthin tumors to malignant parotid gland tumors, only three parameters (ADC_mean, ADC_50th, skewness) were statistically significant (all p < 0.05). Conclusions Whole-lesion ADC histograms are effective in differentiating common parotid gland tumors.

scholarly journals T2 and DWI in Pilocytic and Pilomyxoid Astrocytoma with Pathologic Correlation

2012 ◽  
Vol 39 (4) ◽  
pp. 491-498 ◽  
Author(s):  
M. Horger ◽  
M. N. Vogel ◽  
R. Beschorner ◽  
U. Ernemann ◽  
J. Wörner ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Signal Intensity ◽  
Imaging Features ◽  
Pilomyxoid Astrocytoma ◽  
Diffusion Weighted Images ◽  
Significant Difference ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Myxoid Matrix

Objective:To quantify and compare T2 signal and apparent diffusion coefficient (ADC) in pilocytic and pilomyxoid astrocytoma (PA and PMA) and correlate results with myxoid content.Methods:Echo-planar diffusion weighted images (DWI) and standard magnetic resonance imaging (MRI) findings were reviewed retrospectively in patients with PA (n=34) and PMA (n=8). Regions of interest (ROIs) were drawn on ADC maps within tumor parts with lowest ADC values. Apparent diffusion coefficient values in tumor were normalized to those in cerebrospinal fluid (ADC/CSF). The ratio of T2 signal intensity in solid tumor parts to CSF (T2/CSF) was registered. Myxoid matrix was histologically quantified retrospectively in 8 PMAs and 17 PAs and correlated with imaging findings.Results:Mean ADC/CSF for PA and PMA was 0.53±0.10 and 0.69±0.10 (p<0.01). Mean T2/CSF for PA and PMA was 0.78±0.19 and 0.93±0.09 (p<0.01). Mean proportion of myxoid tumor matrix in PA was 50% (range, 10-100%) and 93% (range, 90-100%) in PMA (p=0.004). Eight patients (32%; all PA) had less than 50% myxoid content and 17 (68%; 8 PA; 9 PMA) had more. There was positive correlation of ADC/CSF, T2/CSF and ADC (r2=0.61, 0.65 and 0.60 respectively) and significant difference between the groups with more and less than 50% myxoid content (p=0.01 for ADC/CSF and T2/CSF and p=0.02 for ADC).Conclusions:General imaging features of PA and PMA are non-specific, ADC values and T2 signal intensity are generally higher in the latter, reflecting the proportion of myxoid matrix in these tumors.

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