Differential diagnosis of parotid gland tumours: Application of SWI combined with DWI and DCE-MRI. Issue 146 (January 2022)

• Record Type: Journal Article
• Authors: Xu, Zhuangyong; Chen, Meiwei; Zheng, Shaoyan; Chen, Shaoxian; Xiao, Jianning; Hu, Zehuan; Lu, Liejing; Yang, Zehong; Lin, Daiying
• Is Part Of: European journal of radiology. Issue 146(2022)
• Publication Date: 2022-01
• Subjects: PTs Parotid tumours -- CT computed tomography -- MRI magnetic resonance imaging -- DWI diffusion-weighted imaging -- DCE-MRI dynamic contrast-enhanced magnetic resonance imaging -- ADC apparent diffusion coefficient -- WTs Warthin tumours -- TIC time-intensity curve -- EES extracellular extravascular space -- Ktrans volume transfer constant between blood plasma and EES -- Ve EES fractional volume -- Kep flux rate constant between the EES and plasma -- SWI susceptibility-weighted imaging -- ITSS intratumoural susceptibility signal -- SE-T1WI spin-echo T1-weighted imaging -- SE-T2WI spin-echo T2-weighted imaging -- VIBE volume interpolated body examination -- ROIs regions of interest -- ICC intra-class correlation coefficient -- ROC receiver operating characteristic -- AUC area under the curve; Parotid tumours -- Diffusion-weighted imaging -- Dynamic contrast enhancement -- Susceptibility-weighted imaging -- Intratumoural susceptibility signal; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2021.110094
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: The added value of SWI in the differentiation diagnosis of parotid tumours is investigated. SWI is effective for differentiating benign and malignant parotid gland tumours. SWI offers incremental diagnostic value to DWI and DCE-MRI in parotid tumours. Abstract: Background: Parotid tumours (PTs) have a variety of pathological types, and the surgical procedures differ depending on the tumour type. However, accurate diagnosis of PTs from the current preoperative examinations is unsatisfactory. Methods: This retrospective study was approved by the Ethics Committee of our hospital, and the requirement for informed consent was waived. A total of 73 patients with PTs, including 55 benign and 18 malignant tumours confirmed by surgical pathology, were enrolled. All patients underwent diffusion-weighted imaging (DWI), dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), susceptibility-weighted imaging (SWI), T2-weighted imaging (T2WI), and T1-weighted imaging (T1WI). The signal uniformity and capsule on T2WI, apparent diffusion coefficient (ADC) derived from DWI, semi-quantitative parameter time-intensity curve (TIC) pattern, and quantitative parameters including transfer constant (Ktrans ), extravascular extracellular volume fraction (Ve ), wash-out constant (Kep ) calculated from DCE-MRI, and intratumoural susceptibility signal (ITSS) obtained from SWI were assessed and compared between benign and malignant PTs. Logistic regression analysis was used to select the predictive parameters for the classification of benign and malignant parotid gland tumours, and receiver operating characteristic (ROC) curve analysis was used to evaluate their diagnostic performance. Results: Malignant PTs tended to exhibit a type C TIC pattern, whereas benign tumours tended to be type A and B ( p < 0.001). Benign PTs had less ITSS than malignant tumours ( p < 0.001). Multivariate analyses showed that ADC, Ve, and ITSS were predictors of tumour classification. ROC analysis showed that the area under the curve (AUC) of ADC, Ve, ITSS, and ADC combined with Ve were 0.623, 0.615, 0.826, and 0.782, respectively, in differentiating between malignant and benign PTs. When ITSS was added, the AUCs of ADC, Ve, and ADC combined with Ve increased to 0.882, 0.848, and 0.930, respectively. Conclusion: SWI offers incremental diagnostic value to DWI and DCE-MRI in the characterisation of parotid gland tumours.