Abstract | PURPOSE: This study aimed to evaluate the value of diffusion-weighted imaging (DWI) and gadolinium-enhanced dynamic magnetic resonance imaging (MRI) for differentiating benign and malignant parotid gland tumors, and for characterizing the various histological types ( pleomorphic adenoma, and Warthin's and malignant tumors). PATIENTS AND METHODS: This retrospective study involved 60 patients with suspected parotid gland tumors (mean age: 59.4 years), and was carried out from April 2005 to February 2008. All had undergone pathological examination. All MRI examinations were performed using the Siemens Magnetom Avanto 1.5T MRI system. Non-enhanced T1-weighted (T1W), gadolinium-enhanced fat-suppressed T1W and T2-weighted (T2W) images were obtained for all 60 patients, with diffusion-weighted echoplanar imaging (DW-EPI) and apparent diffusion coefficient (ADC) evaluation in 59 patients, and gadolinium-enhanced dynamic MRI sequences in 51 patients. Interpretation was carried out by two experienced radiologists (the first evaluation used T1W, gadolinium-enhanced fat-suppressed T1W and T2W images; the second evaluation used T1W, T2W, DWI and dynamic MRI) and, for each case, the benign/malignant nature of the tumor and its histological type were determined. RESULTS: After the second reading, increases were noted in sensitivity, specificity, malignant positive predictive value (PPV) and negative predictive value (NPV), as well as in accuracy (90-100% for the first observer, and 90-97% for the second observer). Interobserver reliability also showed a significant increase from the first to the second reading (kappa=0.63 to 0.87, respectively). CONCLUSION:
Gadolinium-enhanced dynamic MRI and DW-EPI with ADC evaluation improved the performance of MRI in distinguishing between benign and malignant parotid gland tumors, and characterizing the different histological types of benign tumors ( pleomorphic adenoma and Warthin's), thus leading to greater consensus in interpretation of the images.
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Authors | J Lechner Goyault, S Riehm, A Neuville, A Gentine, F Veillon |
Journal | Journal of neuroradiology = Journal de neuroradiologie
(J Neuroradiol)
Vol. 38
Issue 2
Pg. 77-89
(May 2011)
ISSN: 0150-9861 [Print] France |
PMID | 20542568
(Publication Type: Evaluation Study, Journal Article)
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Copyright | Copyright © 2010 Elsevier Masson SAS. All rights reserved. |
Chemical References |
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Algorithms
- Contrast Media
- Diagnosis, Differential
- Female
- Humans
- Image Enhancement
(methods)
- Image Interpretation, Computer-Assisted
(methods)
- Magnetic Resonance Imaging
(methods)
- Male
- Middle Aged
- Parotid Neoplasms
(pathology)
- Reproducibility of Results
- Sensitivity and Specificity
- Young Adult
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