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Improved Performance in Differentiating Benign from Malignant Sinonasal Tumors Using Diffusion-weighted Combined with Dynamic Contrast-enhanced Magnetic Resonance Imaging

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收录情况: ◇ SCIE ◇ 统计源期刊 ◇ CSCD-C ◇ 中华系列

机构: [1]Capital Med Univ, Beijing Tongren Hosp, Dept Radiol, Beijing 100730, Peoples R China [2]Capital Med Univ, Beijing Inst Otolaryngol, Beijing Key Lab Nasal Dis, Beijing 100069, Peoples R China
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关键词: Diffusion-weighted Dynamic Contrast-enhanced Magnetic Resonance Imaging Nasal Cavity Neoplasm Paranasal Sinus

摘要:
Background: Differentiating benign from malignant sinonsal lesions is essential for treatment planning as well as determining the patient's prognosis, but the differentiation is often difficult in clinical practice. The study aimed to determine whether the combination of diffusion-weighted (DW) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can improve the performance in differentiating benign from malignant sinonasal tumors. Methods: This retrospective study included 197 consecutive patients with sinonasal tumors (116 malignant tumors and 81 benign tumors). All patients underwent both DW and DCE-MRI in a 3-T magnetic resonance scanner. Two different settings of b values (0,700 and 0,1000 s/mm(2)) and two different strategies of region of interest (ROI) including whole slice (WS) and partial slice (PS) were used to calculate apparent diffusion coefficients (ADCs). A DW parameter with WS ADCs(b0),(1000) and two DCE-MRI parameters (time intensity curve [TIC] and time to peak enhancement [Tpeak]) were finally combined to use in differentiating the benign from the malignant tumors in this study. Results: The mean ADCs of malignant sinonasal tumors (WS ADCs(b0),(1000) = 1.084 x 10(-3) mm(2)/s) were significantly lower than those of benign tumors (WS ADCs(b0),(1000) = 1.617 x 10(-3) mm(2)/s, P < 0.001). The accuracy using WS ADCs(b0),(1000) alone was 83.7% in differentiating the benign from the malignant tumors (85.3% sensitivity, 81.2% specificity, 86.4% positive predictive value [PPV], and 79.5% negative predictive value [NPV]). The accuracy using DCE with Tpeak and TIC alone was 72.1% (69.1% sensitivity, 74.1% specificity, 77.5% PPV, and 65.1% NPV). Using DW-MRI parameter was superior than using DCE parameters in differentiation between benign and malignant sinonasal tumors (P < 0.001). The accuracy was 87.3% (90.5% sensitivity, 82.7% specificity, 88.2% PPV, and 85.9% NPV) using DW-MRI combined with DCE-MRI, which was superior than that using DCE-MRI alone or using DW-MRI alone (both P < 0.001) in differentiating the benign from the malignant tumors. Conclusions: Diffusion-weighted combined with DCE-MRI can improve imaging performance in differentiating benign from malignant sinonasal tumors, which has the potential to improve diagnostic accuracy and to provide added value in the management for these tumors.

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出版当年[2014]版:
大类 | 4 区 医学
小类 | 4 区 医学:内科
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 医学:内科
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出版当年[2013]版:
Q3 MEDICINE, GENERAL & INTERNAL
最新[2023]版:
Q1 MEDICINE, GENERAL & INTERNAL

影响因子: 最新[2023版] 最新五年平均 出版当年[2013版] 出版当年五年平均 出版前一年[2012版] 出版后一年[2014版]

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第一作者机构: [1]Capital Med Univ, Beijing Tongren Hosp, Dept Radiol, Beijing 100730, Peoples R China
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通讯机构: [1]Capital Med Univ, Beijing Tongren Hosp, Dept Radiol, Beijing 100730, Peoples R China [2]Capital Med Univ, Beijing Inst Otolaryngol, Beijing Key Lab Nasal Dis, Beijing 100069, Peoples R China [*1]Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beiing 100730, China
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