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Manou M, Kanakoglou DS, Loupis T, Vrachnos DM, Theocharis S, Papavassiliou AG, Piperi C. Role of Histone Deacetylases in the Pathogenesis of Salivary Gland Tumors and Therapeutic Targeting Options. Int J Mol Sci 2023; 24:10038. [PMID: 37373187 DOI: 10.3390/ijms241210038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/09/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023] Open
Abstract
Salivary gland tumors (SGTs) comprise a rare and heterogenous category of benign/malignant neoplasms with progressively increasing knowledge of the molecular mechanisms underpinning their pathogenesis, poor prognosis, and therapeutic treatment efficacy. Emerging data are pointing toward an interplay of genetic and epigenetic factors contributing to their heterogeneity and diverse clinical phenotypes. Post-translational histone modifications such as histone acetylation/deacetylation have been shown to actively participate in the pathobiology of SGTs, further suggesting that histone deacetylating factors (HDACs), selective or pan-HDAC inhibitors (HDACis), might present effective treatment options for these neoplasms. Herein, we describe the molecular and epigenetic mechanisms underlying the pathology of the different types of SGTs, focusing on histone acetylation/deacetylation effects on gene expression as well as the progress of HDACis in SGT therapy and the current status of relevant clinical trials.
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Affiliation(s)
- Maria Manou
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Dimitrios S Kanakoglou
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Theodoros Loupis
- Haematology Research Laboratory, Clinical, Experimental Surgery and Translational Research Center, Biomedical Research Foundation, Academy of Athens, 11527 Athens, Greece
| | - Dimitrios M Vrachnos
- Haematology Research Laboratory, Clinical, Experimental Surgery and Translational Research Center, Biomedical Research Foundation, Academy of Athens, 11527 Athens, Greece
| | - Stamatios Theocharis
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Athanasios G Papavassiliou
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Christina Piperi
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Fathi Kazerooni A, Nabil M, Alviri M, Koopaei S, Salahshour F, Assili S, Saligheh Rad H, Aghaghazvini L. Radiomic Analysis of Multi-parametric MR Images (MRI) for Classification of Parotid Tumors. J Biomed Phys Eng 2022; 12:599-610. [PMID: 36569565 PMCID: PMC9759641 DOI: 10.31661/jbpe.v0i0.2007-1140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 11/13/2020] [Indexed: 12/05/2022]
Abstract
Background Characterization of parotid tumors before surgery using multi-parametric magnetic resonance imaging (MRI) scans can support clinical decision making about the best-suited therapeutic strategy for each patient. Objective This study aims to differentiate benign from malignant parotid tumors through radiomics analysis of multi-parametric MR images, incorporating T2-w images with ADC-map and parametric maps generated from Dynamic Contrast Enhanced MRI (DCE-MRI). Material and Methods MRI scans of 31 patients with histopathologically-confirmed parotid gland tumors (23 benign, 8 malignant) were included in this retrospective study. For DCE-MRI, semi-quantitative analysis, Tofts pharmacokinetic (PK) modeling, and five-parameter sigmoid modeling were performed and parametric maps were generated. For each patient, borders of the tumors were delineated on whole tumor slices of T2-w image, ADC-map, and the late-enhancement dynamic series of DCE-MRI, creating regions-of-interest (ROIs). Radiomic analysis was performed for the specified ROIs. Results Among the DCE-MRI-derived parametric maps, wash-in rate (WIR) and PK-derived Ktrans parameters surpassed the accuracy of other parameters based on support vector machine (SVM) classifier. Radiomics analysis of ADC-map outperformed the T2-w and DCE-MRI techniques using the simpler classifier, suggestive of its inherently high sensitivity and specificity. Radiomics analysis of the combination of T2-w image, ADC-map, and DCE-MRI parametric maps resulted in accuracy of 100% with both classifiers with fewer numbers of selected texture features than individual images. Conclusion In conclusion, radiomics analysis is a reliable quantitative approach for discrimination of parotid tumors and can be employed as a computer-aided approach for pre-operative diagnosis and treatment planning of the patients.
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Affiliation(s)
- Anahita Fathi Kazerooni
- PhD, Quantitative MR Imaging and Spectroscopy Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Iran
| | - Mahnaz Nabil
- PhD, Department of Mathematics, Islamic Azad University, Qazvin Branch, Qazvin, Iran
| | - Mohammadreza Alviri
- MSc, Quantitative MR Imaging and Spectroscopy Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Iran
| | - Soheila Koopaei
- MSc, Quantitative MR Imaging and Spectroscopy Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Iran
| | - Faeze Salahshour
- MD, Department of Radiology, Advanced Diagnostic and Invasive Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanam Assili
- MSc, Quantitative MR Imaging and Spectroscopy Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Iran
| | - Hamidreza Saligheh Rad
- PhD, Quantitative MR Imaging and Spectroscopy Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Iran
- PhD, Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Iran
| | - Leila Aghaghazvini
- MD, Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Abstract
Salivary gland tumors (SGTs) make up a small portion (approximately 5%) of all head and neck tumors. Most of them are located in the parotid glands, while they are less frequently located in the submandibular glands, minor salivary glands or sublingual gland. The incidence of malignant or benign tumors (BTs) in the salivary glands varies according to the salivary gland from which they originate. While most of those detected in the parotid gland tend to be benign, the incidence of malignancy increases in other glands. The use of magnetic resonance imaging (MRI) in the diagnosis of SGTs is increasing every day. While conventional sequences provide sufficient data on the presence, localization, extent and number of the tumor, they are insufficient for tumor specification. With the widespread use of advanced techniques such as diffusion-weighted imaging, semi-quantitative and quantitative perfusion MRI, studies and data have been published on the differentiation of malignant or BTs and the specificity of their subtypes. With diffusion MRI, differentiation can be made by utilizing the cellularity and microstructural properties of tumors. For example, SGTs such as high cellular Warthin’s tumor (WT) or lymphoma on diffusion MRI have been reported to have significantly lower apparent diffusion values than other tumors. Contrast agent uptake and wash-out levels of tumors can be detected with semi-quantitative perfusion MRI. For example, it is reported that almost all of the pleomorphic adenomas show an increasing enhancement time intensity curve and do not wash-out. On quantitative perfusion MRI studies using perfusion parameters such as Ktrans, Kep, and Ve, it is reported that WTs can show higher Kep and lower Ve values than other tumors. In this study, the contribution of advanced MRI to the diagnosis and differential diagnosis of SGTs will be reviewed.
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Affiliation(s)
- Erkan Gökçe
- Department of Radiology, Faculty of Medicine, Tokat Gaziosmanpasa University, Tokat 60100, Turkey
| | - Murat Beyhan
- Department of Radiology, Faculty of Medicine, Tokat Gaziosmanpasa University, Tokat 60100, Turkey
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Juan CJ, Huang TY, Liu YJ, Shen WC, Wang CW, Hsu K, Shin N, Chang RF. Improving diagnosing performance for malignant parotid gland tumors using machine learning with multifeatures based on diffusion-weighted magnetic resonance imaging. NMR Biomed 2022; 35:e4642. [PMID: 34738671 DOI: 10.1002/nbm.4642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/18/2021] [Accepted: 10/10/2021] [Indexed: 06/13/2023]
Abstract
In this study, the performance of machine learning in classifying parotid gland tumors based on diffusion-related features obtained from the parotid gland tumor, the peritumor parotid gland, and the contralateral parotid gland was evaluated. Seventy-eight patients participated in this study and underwent magnetic resonance diffusion-weighted imaging. Three regions of interest, including the parotid gland tumor, the peritumor parotid gland, and the contralateral parotid gland, were manually contoured for 92 tumors, including 20 malignant tumors (MTs), 42 Warthin tumors (WTs), and 30 pleomorphic adenomas (PMAs). We recorded multiple apparent diffusion coefficient (ADC) features and applied a machine-learning method with the features to classify the three types of tumors. With only mean ADC of tumors, the area under the curve of the classification model was 0.63, 0.85, and 0.87 for MTs, WTs, and PMAs, respectively. The performance metrics were improved to 0.81, 0.89, and 0.92, respectively, with multiple features. Apart from the ADC features of parotid gland tumor, the features of the peritumor and contralateral parotid glands proved advantageous for tumor classification. Combining machine learning and multiple features provides excellent discrimination of tumor types and can be a practical tool in the clinical diagnosis of parotid gland tumors.
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Affiliation(s)
- Chun-Jung Juan
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan, Republic of China
- Department of Medical Imaging, China Medical University Hsinchu Hospital, Hsinchu, Taiwan, Republic of China
- Department of Radiology, School of Medicine, China Medical University, Taichung, Taiwan, Republic of China
- Department of Medical Imaging, China Medical University Hospital, Taichung, Taiwan, Republic of China
| | - Teng-Yi Huang
- Department of Electrical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan, Republic of China
| | - Yi-Jui Liu
- Department of Automatic Control Engineering, Feng Chia University, Taichung, Taiwan, Republic of China
| | - Wu-Chung Shen
- Department of Radiology, School of Medicine, China Medical University, Taichung, Taiwan, Republic of China
- Department of Medical Imaging, China Medical University Hospital, Taichung, Taiwan, Republic of China
| | - Chih-Wei Wang
- Department of Radiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Kang Hsu
- Department of Dentistry, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
| | - Nieh Shin
- Department of Pathology and Graduate Institute of Pathology and Parasitology, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Ruey-Feng Chang
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan, Republic of China
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Chang Y, Huang T, Liu Y, Chung H, Juan C. Classification of parotid gland tumors by using multimodal MRI and deep learning. NMR Biomed 2021; 34:e4408. [PMID: 32886955 PMCID: PMC7757221 DOI: 10.1002/nbm.4408] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 08/01/2020] [Accepted: 08/21/2020] [Indexed: 05/05/2023]
Abstract
Various MRI sequences have shown their potential to discriminate parotid gland tumors, including but not limited to T2 -weighted, postcontrast T1 -weighted, and diffusion-weighted images. In this study, we present a fully automatic system for the diagnosis of parotid gland tumors by using deep learning methods trained on multimodal MRI images. We used a two-dimensional convolution neural network, U-Net, to segment and classify parotid gland tumors. The U-Net model was trained with transfer learning, and a specific design of the batch distribution optimized the model accuracy. We also selected five combinations of MRI contrasts as the input data of the neural network and compared the classification accuracy of parotid gland tumors. The results indicated that the deep learning model with diffusion-related parameters performed better than those with structural MR images. The performance results (n = 85) of the diffusion-based model were as follows: accuracy of 0.81, 0.76, and 0.71, sensitivity of 0.83, 0.63, and 0.33, and specificity of 0.80, 0.84, and 0.87 for Warthin tumors, pleomorphic adenomas, and malignant tumors, respectively. Combining diffusion-weighted and contrast-enhanced T1 -weighted images did not improve the prediction accuracy. In summary, the proposed deep learning model could classify Warthin tumor and pleomorphic adenoma tumor but not malignant tumor.
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Affiliation(s)
- Yi‐Ju Chang
- Department of Electrical EngineeringNational Taiwan University of Science and TechnologyTaipeiTaiwan
| | - Teng‐Yi Huang
- Department of Electrical EngineeringNational Taiwan University of Science and TechnologyTaipeiTaiwan
| | - Yi‐Jui Liu
- Department of Automatic Control EngineeringFeng Chia UniversityTaichungTaiwan
| | - Hsiao‐Wen Chung
- Department of Electrical EngineeringNational Taiwan UniversityTaipeiTaiwan
| | - Chun‐Jung Juan
- Department of Medical ImagingChina Medical University Hsinchu HospitalHsinchuTaiwan
- Department of Radiology, School of Medicine, College of MedicineChina Medical UniversityTaichungTaiwan
- Department of Medical ImagingChina Medical University HospitalTaichungTaiwan
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Karaman CZ, Tanyeri A, Özgür R, Öztürk VS. Parotid gland tumors: comparison of conventional and diffusion-weighted MRI findings with histopathological results. Dentomaxillofac Radiol 2020; 50:20200391. [PMID: 33237812 DOI: 10.1259/dmfr.20200391] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
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.
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Affiliation(s)
- Can Zafer Karaman
- Department of Radiology, Aydın Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Ahmet Tanyeri
- Department of Radiology, Aydın Adnan Menderes University School of Medicine, Aydın, Turkey.,Department of Radiology, Yozgat City Hospital, Yozgat, Turkey
| | - Recep Özgür
- Department of Radiology, Aydın Adnan Menderes University School of Medicine, Aydın, Turkey.,Department of Radiology, Devrek State Hospital, Zonguldak, Turkey
| | - Veli Süha Öztürk
- Department of Radiology, Aydın Adnan Menderes University School of Medicine, Aydın, Turkey.,Department of Radiology, Salihli State Hospital, Manisa, Turkey
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Coudert H, Mirafzal S, Dissard A, Boyer L, Montoriol PF. Multiparametric magnetic resonance imaging of parotid tumors: A systematic review. Diagn Interv Imaging 2020; 102:121-130. [PMID: 32943368 DOI: 10.1016/j.diii.2020.08.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 08/05/2020] [Accepted: 08/11/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE The purpose of this systematic review was to provide an overview of the contribution of multiparametric magnetic resonance imaging (MRI) in the diagnosis of parotid tumors (PT) and recommendations based on current evidences. MATERIAL AND METHODS We performed a retrospective systematic search of PubMed, EMBASE, and Cochrane Library databases from inception to January 2020, using the keywords "magnetic resonance imaging" and "salivary gland neoplasms". RESULTS The initial search returned 2345 references and 90 were deemed relevant for this study. A total of 54 studies (60%) reported the use of diffusion-weighted imaging (DWI) and 28 studies (31%) the use of dynamic contrast-enhanced (DCE) imaging. Specific morphologic signs of frequent benign PT and suggestive signs of malignancy on conventional sequences were reported in 37 studies (41%). DWI showed significant differences in apparent diffusion coefficient (ADC) values between benign and malignant PT, and especially between pleomorphic adenomas and malignant PT, with cut-off ADC values between 1.267×10-3mm2/s and 1.60×10-3mm2/s. Perfusion curves obtained with DCE imaging allowed differentiating among pleomorphic adenomas, Warthin's tumors, malignant PT and cystic lesions. The combination of morphological MRI sequences, DCE imaging and DWI helped increase the diagnostic accuracy of MRI. CONCLUSION Multiparametric MRI, including morphological MRI sequences, DWI and DCE imaging, is the imaging modality of choice for the characterization of focal PT and provides features that are highly suggestive of a specific diagnosis.
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Affiliation(s)
- H Coudert
- Department of Neuroradiology, University Hospital Gabriel-Montpied, 63000 Clermont-Ferrand, France.
| | - S Mirafzal
- Department of Neuroradiology, University Hospital Gabriel-Montpied, 63000 Clermont-Ferrand, France
| | - A Dissard
- Department of Otolaryngology and Head and Neck Surgery, University Hospital Gabriel-Montpied, 63000 Clermont-Ferrand, France
| | - L Boyer
- Department of Vascular Radiology, University Hospital Gabriel-Montpied, UMR Auvergne CNRS 6284, 63000 Clermont-Ferrand, France
| | - P-F Montoriol
- Department of Radiology, Centre Jean-Perrin, 63000 Clermont-Ferrand, France
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Messina C, Bignone R, Bruno A, Bruno A, Bruno F, Calandri M, Caruso D, Coppolino P, Robertis R, Gentili F, Grazzini I, Natella R, Scalise P, Barile A, Grassi R, Albano D. Diffusion-Weighted Imaging in Oncology: An Update. Cancers (Basel) 2020; 12:E1493. [PMID: 32521645 DOI: 10.3390/cancers12061493] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/28/2020] [Accepted: 06/01/2020] [Indexed: 02/06/2023] Open
Abstract
To date, diffusion weighted imaging (DWI) is included in routine magnetic resonance imaging (MRI) protocols for several cancers. The real additive role of DWI lies in the "functional" information obtained by probing the free diffusivity of water molecules into intra and inter-cellular spaces that in tumors mainly depend on cellularity. Although DWI has not gained much space in some oncologic scenarios, this non-invasive tool is routinely used in clinical practice and still remains a hot research topic: it has been tested in almost all cancers to differentiate malignant from benign lesions, to distinguish different malignant histotypes or tumor grades, to predict and/or assess treatment responses, and to identify residual or recurrent tumors in follow-up examinations. In this review, we provide an up-to-date overview on the application of DWI in oncology.
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Liu YJ, Lee YH, Chang HC, Chung HW, Wang CW, Juan CH, Chu YH, Lee JC, Juan CJ. Imaging quality of PROPELLER diffusion-weighted MR imaging and its diagnostic performance in distinguishing pleomorphic adenomas from Warthin tumors of the parotid gland. NMR Biomed 2020; 33:e4282. [PMID: 32124504 DOI: 10.1002/nbm.4282] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 02/03/2020] [Accepted: 02/04/2020] [Indexed: 06/10/2023]
Abstract
The aim of this study was to evaluate the imaging quality and diagnostic performance of fast spin echo diffusion-weighted imaging with periodically rotated overlapping parallel lines with enhanced reconstruction (FSE-PROP-DWI) in distinguishing parotid pleomorphic adenoma (PMA) from Warthin tumor (WT). This retrospective study enrolled 44 parotid gland tumors from 34 patients, including 15 PMAs and 29 WTs with waived written informed consent. All participants underwent 1.5 T diffusion-weighted imaging including FSE-PROP-DWI and single-shot echo-planar diffusion-weighted imaging (SS-EP-DWI). After imaging resizing and registration among T2WI, FSE-PROP-DWI and SS-EP-DWI, imaging distortion was quantitatively analyzed by using the Dice coefficient. Signal-to-noise ratio and contrast-to-noise ratio were qualitatively evaluated. The mean apparent diffusion coefficient (ADC) of parotid gland tumors was calculated. Wilcoxon signed-rank test was used for paired comparison between FSE-PROP-DWI versus SS-EP-DWI. Mann-Whitney U test was used for independent group comparison between PMAs versus WTs. Diagnostic performance was evaluated by receiver operating characteristics curve analysis. P < 0.05 was considered statistically significant. The Dice coefficient was statistically significantly higher on FSE-PROP-DWI than SS-EP-DWI for both tumors (P < 0.005). Mean ADC was statistically significantly higher in PMAs than WTs on both FSE-PROP-DWI and SS-EP-DWI (P < 0.005). FSE-PROP-DWI and SS-EP-DWI successfully distinguished PMAs from WTs with an AUC of 0.880 and 0.945, respectively (P < 0.05). Sensitivity, specificity, positive predictive value, negative predictive value and accuracy in diagnosing PMAs were 100%, 69.0%, 62.5%, 100% and 79.5% for FSE-PROP-DWI, and 100%, 82.8%, 75%, 100% and 88.6% for SS-EP-DWI, respectively. FSE-PROP-DWI is useful to distinguish parotid PMAs from WTs with less distortion of tumors but lower AUC than SS-EP-DWI.
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Affiliation(s)
- Yi-Jui Liu
- Department of Automatic Control Engineering, Feng Chia University, Taichung, Taiwan, Republic of China
| | - Yi-Hsiung Lee
- Electrical and Communication Engineering, Feng Chia University, Taichung, Taiwan, Republic of China
- Department of Radiology, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
| | - Hing-Chiu Chang
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong, China
| | - Hsiao-Wen Chung
- Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Chih-Wei Wang
- Department of Radiology, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
| | - Cheng-Hsuan Juan
- Department of Automatic Control Engineering, Feng Chia University, Taichung, Taiwan, Republic of China
| | - Yueng-Hsiang Chu
- Department of Otolaryngology-Head & Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
| | - Jih-Chin Lee
- Department of Otolaryngology-Head & Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
| | - Chun-Jung Juan
- Department of Medical Imaging, China Medical University Hsinchu Hospital, Hsinchu, Taiwan, Republic of China
- Department of Radiology, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan, Republic of China
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Gökçe E. Multiparametric Magnetic Resonance Imaging for the Diagnosis and Differential Diagnosis of Parotid Gland Tumors. J Magn Reson Imaging 2020; 52:11-32. [PMID: 32065489 DOI: 10.1002/jmri.27061] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 01/02/2020] [Accepted: 01/03/2020] [Indexed: 12/18/2022] Open
Abstract
The majority of salivary gland tumors occur in the parotid glands. Characterization (ie, benign or malignant, and histological type), location (deep or superficial), and invasion into the neighboring tissues of parotid tumors determine preoperative treatment planning. MRI gives more information than other imaging methods about the internal structure, localization, and relationship with other tissues of parotid tumors. Functional MRI methods (diffusion-weighted imaging, dynamic contrast-enhanced MRI, perfusion-weighted MRI, MR spectroscopy, etc.) have been increasingly used recently to increase the power of radiologists to characterize the tumors. Although they increase the workload of radiologists, the combined use of functional MRI methods improves accuracy in the differentiation of the tumors. There are a wide range of studies in the literature dealing with the combined use of different functional imaging methods in combination with conventional sequences. The aim of the present review is to evaluate conventional and functional/advanced MR methods, as well as multiparametric MRI applications combining them in the diagnosis of parotid gland tumors. Evidence Level: 5 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2020;52:11-32.
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Affiliation(s)
- Erkan Gökçe
- Department of Radiology, Medical School, Tokat Gaziosmanpaşa University, Tokat, Turkey
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Munhoz L, Ramos EADA, Im DC, Hisatomi M, Yanagi Y, Asaumi J, Arita ES. Application of diffusion-weighted magnetic resonance imaging in the diagnosis of salivary gland diseases: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:280-310. [DOI: 10.1016/j.oooo.2019.02.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/16/2019] [Accepted: 02/22/2019] [Indexed: 01/02/2023]
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Sun Q, Ma C, Dong M, Jiang M, Tao X. Effects of region of interest sizes on apparent diffusion coefficient measurements of pleomorphic adenoma, Warthin tumor, and normal parotid parenchyma. Quant Imaging Med Surg 2019; 9:681-690. [PMID: 31143659 DOI: 10.21037/qims.2019.04.11] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Background Tumor apparent diffusion coefficient (ADC) measurements may be influenced by region of interest (ROI) sizes; however, this effect has not been systematically studied in parotid tumors. Our purpose was to determine the effects of ROI size on ADC measurements for the differentiation of pleomorphic adenoma (PA), Warthin tumor (WT), and normal parotid parenchyma. Methods Sixty-five patients including 37 with PA (lesions, n=37) and 28 with WT (lesions, n=36) were examined with diffusion-weighted imaging (DWI). Participants with normal contralateral parenchyma of the parotid gland constituted the control group (n=56). The mean ADC values and standard deviations (SDs) of the ADC (ADCSD) of 12 concentric round ROIs (areas: 9, 28, 34, 50, 60, 82, 93, 98, 115, 130, 136, and 149 mm2) for tumors and normal tissue were measured by using custom-made software. Homogeneity index, which was defined by the ADCSD/mean ADC, was also calculated. One-way repeated analyses of variance (ANOVAs) were performed on the mean ADCs, ADCSDs, and homogeneity indices of the 12 ROIs in each group. The three parameters at different ROIs among PA, WT, and normal parotid parenchyma were compared using Kruskal-Wallis tests. Results There was excellent agreement for the ADC measurements with the 12 ROIs for PA [intraclass correlation coefficient (ICC), 0.98], WT (ICC, 0.99), and normal parotid parenchyma (ICC, 0.95). No significant differences were observed in the mean ADCs of the 12 ROIs for each of the three groups (P=0.744-0.990). Among the three groups, the mean ADC of normal parotid parenchyma [(0.94±0.003)×10-3 mm2/s] was significantly lower than that of both PA [(1.72±0.01)×10-3 mm2/s] and WT [(1.16±0.01)×10-3 mm2/s] in the 12 ROIs, whereas the PA group had the highest mean ADC values. No significant differences were found in the mean ADCSDs with each ROI between PA and WT (all P>0.017). PAs had lower homogeneity indices compared with WTs and normal parotid parenchyma (all P<0.01). Conclusions The effect of ROI size on ADC measurements could be excluded from the differentiation of PA, WT, and normal parotid parenchyma. Homogeneity index was a useful parameter in discriminating between the three groups.
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Affiliation(s)
- Qi Sun
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Chao Ma
- Department of Radiology, Changhai Hospital of Shanghai, The Naval Military Medical University, Shanghai 200433, China
| | - Minjun Dong
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Mengda Jiang
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Xiaofeng Tao
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
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Abstract
In patients with head and neck cancer, conventional anatomical magnetic resonance imaging (MRI) scans are commonly used for identification of primary lesion, assessment of structural distortion, and presence of metastatic lymph nodes. However, quantitative analysis of diffusion MRI can provide added value to structural and anatomical evaluation of head and neck tumors (HNT), by differentiation of primary malignant process, prognostic prediction, and treatment monitoring. In this article, we will review the applications of quantitative diffusion MRI in identification of primary malignant tissue, differentiation of tumor pathology, prediction of molecular phenotype, monitoring of treatment response, and evaluation of posttreatment changes in patient with HNT.
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Affiliation(s)
- Seyedmehdi Payabvash
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
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Khamis ME, Ahmed AF, Ismail EI, Bayomy MF, El-Anwar MW. The diagnostic efficacy of apparent diffusion coefficient value and Choline/Creatine ratio in differentiation between parotid gland tumors. The Egyptian Journal of Radiology and Nuclear Medicine 2018. [DOI: 10.1016/j.ejrnm.2018.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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Wang CW, Chu YH, Chiu DY, Shin N, Hsu HH, Lee JC, Juan CJ. JOURNAL CLUB: The Warthin Tumor Score: A Simple and Reliable Method to Distinguish Warthin Tumors From Pleomorphic Adenomas and Carcinomas. AJR Am J Roentgenol 2018; 210:1330-7. [PMID: 29667889 DOI: 10.2214/AJR.17.18492] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The objective of this article is to propose a Warthin tumor (WT) score to distinguish WTs from other parotid tumors. MATERIALS AND METHODS The study included 78 patients with 92 histologically proven parotid tumors, including 42 WTs, 30 pleomorphic adenomas (PMAs), and 20 carcinomas. Echo-planar DW images were acquired. The WT score, which comprised the mean apparent diffusion coefficient (ADCM) and the SD of the ADC (ADCSD) of tumors, patient age, and patient sex, was used to predict WTs. The diagnostic performance of the WT score was evaluated using ROC analyses. Statistical significance was denoted by p < 0.05. RESULTS With the use of optimized criteria, including an ADCM less than or equal to 1.016 × 10-3 mm2/s (WT score, 1), an ADCSD less than or equal to 0.1171 × 10-3 mm2/s (WT score, 1), patient age older than 49 years (WT score, 1), and male sex (WT score, 1), a WT score greater than 2 had a sensitivity, specificity, positive negative value, negative predictive value, and accuracy of 85.7%, 100.0%, 100.0%, 89.3%, and 93.4%, respectively. CONCLUSION The WT score allows parotid WTs to be distinguished from PMAs and carcinomas with high accuracy.
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Ahmed Sultan A, Hanyal-backry M, Mohamed Alhefney E, Ezzat Mosa A, Elmetwally Abdallah Farahat H. Role of MR spectroscopy and diffusion-weighted imaging in diagnosis of orbital masses. The Egyptian Journal of Radiology and Nuclear Medicine 2018; 49:45-53. [DOI: 10.1016/j.ejrnm.2017.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
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Zhang W, Zuo Z, Luo N, Liu L, Jin G, Liu J, Su D. Non-enhanced MRI in combination with color Doppler flow imaging for improving diagnostic accuracy of parotid gland lesions. Eur Arch Otorhinolaryngol 2018; 275:987-95. [PMID: 29430614 DOI: 10.1007/s00405-018-4895-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 01/30/2018] [Indexed: 01/05/2023]
Abstract
PURPOSE To determine the value of non-enhanced MRI in combination with color Doppler flow imaging (CDFI) for differentiating malignant parotid tumors from benign ones. METHODS This retrospective study analyzed 51 parotid gland lesions (39 benign and 12 malignant) in 51 patients who underwent preoperative CDFI as well as non-enhanced MRI including T1-weighted, T2-weighted, and diffusion-weighted imaging (DWI). Degrees of intratumor vascularity were categorized into four grades basing on CDFI findings. The relationships between the lesion and its adjacent external carotid artery and retromandibular vein were inspected on T1-weighted and T2-weighted images. Apparent diffusion coefficient (ADC) values were calculated from diffusion-weighted images, and were used to classify the parotid gland lesions with and without reference to the CDFI findings. The classification results were compared using the McNemar test. Sensitivity, specificity, and accuracy percentages were calculated when the non-enhanced MRI/CDFI findings were used to differentiate benign lesions from malignant ones. RESULTS The diagnostic accuracy (96.1 vs 82.4%) was significantly improved when ADCs were used together with CDFI findings for classifying parotid gland lesions compared to when ADCs were used alone. Pleomorphic adenomas had the highest ADCs. The ADC thresholds were 1.425 × 10-3 mm2/s for differentiating pleomorphic adenomas from carcinomas, 0.999 × 10-3 mm2/s for differentiating pleomorphic adenomas from other benign lesions, and 0.590 × 10-3 mm2/s for differentiating benign lesions other than pleomorphic adenomas from lymphomas. CONCLUSION Combining CDFI with non-enhanced MRI can improve the diagnostic accuracy of MRI for classifying parotid gland lesions.
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Aro K, Tarkkanen J, Saat R, Saarilahti K, Mäkitie A, Atula T. Submandibular gland cancer: Specific features and treatment considerations. Head Neck 2017; 40:154-162. [PMID: 29083518 DOI: 10.1002/hed.24981] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 09/15/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND In the absence of unified treatment protocol, we evaluated the management and outcomes of submandibular gland cancers in an unselected patient series. METHODS We included all patients with resected submandibular gland cancer treated at the Helsinki University Hospital from 2000 to 2010 with a 5-year minimum follow-up. RESULTS Twenty-five patients with cancer represented 30% of submandibular gland neoplasms, and most were adenoid cystic carcinomas (ACCs; 56%). At presentation, 3 patients showed clinical signs of probable malignancy. Of 22 neck dissection specimens, 5 patients (20%) had metastases with an occult metastasis rate of 4%. Cancer recurred in 11 patients (44%), of which 7 (28%) were only at a distant site. The 5-year disease-specific survival (DSS) and overall survival (OS) rates were 76%, and disease-free survival (DFS) was 68%. CONCLUSION Most tumors were ACCs differing from the histological pattern of parotid gland cancers. Occult metastases were rare. The rarity of submandibular gland cancer, its variable histological pattern, and varying biological behavior warrant centralized management.
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Affiliation(s)
- Katri Aro
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,School of Dentistry, University of California, Los Angeles, Los Angeles, California
| | - Jussi Tarkkanen
- Department of Pathology, HUSLAB, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Riste Saat
- Department of Radiology, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Kauko Saarilahti
- Department of Radiation Oncology, HUS Cancer Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Antti Mäkitie
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo Atula
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Das A, Bhalla AS, Sharma R, Kumar A, Sharma M, Gamanagatti S, Thakar A, Sharma S. Benign neck masses showing restricted diffusion: Is there a histological basis for discordant behavior? World J Radiol 2016; 8:174-182. [PMID: 26981226 PMCID: PMC4770179 DOI: 10.4329/wjr.v8.i2.174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 08/27/2015] [Accepted: 12/21/2015] [Indexed: 02/06/2023] Open
Abstract
Diffusion weighted imaging (DWI) evolved as a complementary tool to morphologic imaging by offering additional functional information about lesions. Although the technique utilizes movement of water molecules to characterize biological tissues in terms of their cellularity, there are other factors related to the histological constitution of lesions which can have a significant bearing on DWI. Benign lesions with atypical histology including presence of lymphoid stroma, inherently increased cellularity or abundant extracellular collagen can impede movement of water molecules similar to malignant tissues and thereby, show restricted diffusion. Knowledge of these atypical entities while interpreting DWI in clinical practice can avoid potential misdiagnosis. This review aims to present an imaging spectrum of such benign neck masses which, owing to their distinct histology, can show discordant behavior on DWI.
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Karaman Y, Özgür A, Apaydın D, Özcan C, Arpacı R, Duce MN. Role of diffusion-weighted magnetic resonance imaging in the differentiation of parotid gland tumors. Oral Radiol 2016; 32:22-32. [DOI: 10.1007/s11282-015-0203-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Salama AA, El-barbary AH, Mlees MA, Esheba GES. Value of apparent diffusion coefficient and magnetic resonance spectroscopy in the identification of various pathological subtypes of parotid gland tumors. The Egyptian Journal of Radiology and Nuclear Medicine 2015; 46:45-52. [DOI: 10.1016/j.ejrnm.2014.09.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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Taha MS, Amir M, Hassan O, Sabra R, Taha T, Riad MA. Pre-treatment apparent diffusion coefficient mapping: differentiation of benign from malignant laryngeal lesions. J Laryngol Otol 2015; 129:57-62. [DOI: 10.1017/s0022215114003338] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:To determine whether a threshold apparent diffusion coefficient value may help to differentiate laryngeal carcinomas from benign lesions.Methods:Fifty-three patients with laryngeal masses were recruited; four of them were excluded because of susceptibility artefacts. In the remaining 49 patients, the pathological results showed 32 laryngeal carcinomas and 17 benign lesions. The diagnostic value of diffusion-weighted magnetic resonance imaging for the identification of malignant lesions was determined. In addition, the agreement between diffusion-weighted magnetic resonance imaging and histopathology was assessed. Moreover, the sensitivity, specificity, and negative and positive predictive values of the apparent diffusion coefficient in detecting benign and malignant lesions were analysed. An apparent diffusion coefficient histogram was also produced.Results:An apparent diffusion coefficient value of 1.1 × 10−3 mm2/second produced the best result when used as the cut-off point to differentiate malignant from benign masses.Conclusion:An apparent diffusion coefficient threshold of 1.1 × 10−3 mm2/second is optimal for distinguishing laryngeal carcinomas from benign lesions. Apparent diffusion coefficient values were lower for patients with laryngeal carcinomas than for those with benign lesions.
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Jahidi A, Hemmaoui B, Noureddine E, Youssef D, Issam R, Hafsa C, Benariba F. [Rare association of a pleomorphic adenoma and epithelial myoepithelial carcinoma of the parotid gland]. Pan Afr Med J 2014; 18:27. [PMID: 25368716 PMCID: PMC4214566 DOI: 10.11604/pamj.2014.18.27.4203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 05/05/2014] [Indexed: 11/17/2022] Open
Abstract
Le Carcinome épithélial - myoépithélial (CEM) est une tumeur maligne rare des glandes salivaires touchant principalement la glande parotide. Son association avec un adénome pléomorphe est exceptionnelle. Nous rapportons le cas d'une femme de 57 ans avec adénome pléomorphe de la glande parotide évoluant depuis plusieurs années. L'augmentation récente du volume de la glande associée à l'apparition d'adénopathies cervicales homolatérales nous a fait penser à une transformation maligne. L'examen histologique final après parotidectomie totale a montré une association inattendue d'un adénome pléomorphe et un CEM. Le CEM est une tumeur maligne de bas grade. Elle peut survenir de novo ou sur un adénome pléomorphe. La transformation maligne de l'adénome est suspectée devant l'augmentation rapide du volume de l'adénome avec apparition d'adénopathies cervicales. Toutefois, ces modifications cliniques peuvent annoncer l'apparition d'une tumeur distincte. Malgré sa tendance à la récidive locale et un faible potentiel métastatique, de rares cas de CEM peuvent avoir un comportement agressif et des métastases à distance. Le traitement consiste principalement en une résection chirurgicale complète si possible suivie d'une radiothérapie dans le but de prévenir la récidive locale.
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Affiliation(s)
- Ali Jahidi
- Service ORL et CCF Hôpital Militaire d'Instruction Mohammed V, Rabat, Maroc
| | - Bouchaib Hemmaoui
- Service ORL et CCF Hôpital Militaire d'Instruction Mohammed V, Rabat, Maroc
| | - Errami Noureddine
- Service ORL et CCF Hôpital Militaire d'Instruction Mohammed V, Rabat, Maroc
| | - Darouassi Youssef
- Service ORL et CCF Hôpital Militaire d'Instruction Mohammed V, Rabat, Maroc
| | - Rharrasi Issam
- Service d'Anatomo-Pathologie Hôpital Militaire d'Instruction Mohammed V, Rabat, Maroc
| | - Chahdi Hafsa
- Service d'Anatomo-Pathologie Hôpital Militaire d'Instruction Mohammed V, Rabat, Maroc
| | - Fouad Benariba
- Service ORL et CCF Hôpital Militaire d'Instruction Mohammed V, Rabat, Maroc
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Salem F, Elshafey R, Elmahalawy M, Elshaeny S. Apparent diffusion coefficient measurements in the differentiation between benign and malignant neck masses. The Egyptian Journal of Radiology and Nuclear Medicine 2014; 45:367-75. [DOI: 10.1016/j.ejrnm.2014.01.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Mantsopoulos K, Psychogios G, Agaimy A, Künzel J, Zenk J, Iro H, Bohr C. Inflamed benign tumors of the parotid gland: Diagnostic pitfalls from a potentially misleading entity. Head Neck 2014; 37:23-9. [DOI: 10.1002/hed.23541] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 08/22/2013] [Accepted: 10/24/2013] [Indexed: 12/24/2022] Open
Affiliation(s)
- Konstantinos Mantsopoulos
- Department of Otorhinolaryngology, Head and Neck Surgery; University of Erlangen-Nuremberg; Erlangen Germany
| | - Georgios Psychogios
- Department of Otorhinolaryngology, Head and Neck Surgery; University of Erlangen-Nuremberg; Erlangen Germany
| | - Abbas Agaimy
- Department of Pathology; University of Erlangen-Nuremberg; Erlangen Germany
| | - Julian Künzel
- Department of Otorhinolaryngology, Head and Neck Surgery; University of Erlangen-Nuremberg; Erlangen Germany
| | - Johannes Zenk
- Department of Otorhinolaryngology, Head and Neck Surgery; University of Erlangen-Nuremberg; Erlangen Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology, Head and Neck Surgery; University of Erlangen-Nuremberg; Erlangen Germany
| | - Christopher Bohr
- Department of Otorhinolaryngology, Head and Neck Surgery; University of Erlangen-Nuremberg; Erlangen Germany
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Cakir O, Arslan A, Inan N, Anık Y, Sarısoy T, Gumustas S, Akansel G. Comparison of the diagnostic performances of diffusion parameters in diffusion weighted imaging and diffusion tensor imaging of breast lesions. Eur J Radiol 2013; 82:e801-6. [PMID: 24099642 DOI: 10.1016/j.ejrad.2013.09.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 08/28/2013] [Accepted: 09/03/2013] [Indexed: 01/01/2023]
Abstract
PURPOSE To evaluate the diagnostic efficiency of the diffusion parameters measured by conventional diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI) for discrimination of malignant breast lesions from benign lesions and the normal breast. MATERIALS AND METHODS The study included 52 women with 55 breast lesions (30 malignant, 25 benign). DTI and DWI were performed complementary to dynamic contrast MRI at 3T. Apparent diffusion coefficient (ADC) of DWI, mean diffusivity (MD) and fractional anisotropy (FA) values of DTI were measured for lesions and contralateral breast parenchyma in each patient. We used b factors of 0, 50, 850, 1000 and 1500 s/mm(2) for DWI and b 0 and 1000 s/mm(2) for DTI. ADC, MD and FA values were compared between malignant and benign lesions, and the normal parenchyma by univariate and multivariate analyses. RESULTS Diffusion parameters showed no difference according to menopausal status in the normal breast. ADC and MD values of the malignant lesions were significantly lower than benign lesions and normal parenchyma (p=0.001). The FA showed no statistical significance. With the cut-off values of ≤ 1.23 × 10(-3)mm(2)/s (b 0-1000 s/mm(2)) and ≤ 1.12 × 10(-3)mm(2)/s (b 0-1500 s/mm(2)), ADC showed 92.85% and 96.15% sensitivity; 72.22% and 73.52% PPV, respectively. With a cut-off value of ≤ 1.27 × 10(-3)mm(2)/s (b 1000 s/mm(2)), MD was 100% sensitive with a PPV of 65.90%. Comparing the diagnostic performance of the parameters in DTI with DWI, we obtained similar efficiency of ADC with b values of 0,1000 and 0,1500 s/mm(2) and MD with a b value of 0, 1000 s/mm(2) (AUC = 0.82 ± 0.07). CONCLUSION ADC of DWI and MD of DTI values provide significant discriminative factors for benign and malignant breast lesions. FA measurement was not discriminative. Supported with clinical and dynamic contrast MRI findings, DWI and DTI findings provide significant contribution to the final radiologic decision.
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Affiliation(s)
- Ozgur Cakir
- Kocaeli University Faculty of Medicine, Department of Radiology, 41380 Kocaeli, Turkey.
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Omar EA. The Outline of Prognosis and New Advances in Diagnosis of Oral Squamous Cell Carcinoma (OSCC): Review of the Literature. ACTA ACUST UNITED AC 2013; 2013:1-13. [DOI: 10.1155/2013/519312] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Objective. Oral squamous cell carcinoma (OSCC) has a remarkable incidence over the world and a fairly strenuous prognosis, encouraging further research on the prognostic factors and new techniques for diagnosis that might modify disease outcome. Data Sources. A web-based search for all types of articles published was initiated using Medline/Pub Med, with the key words such as oral cancer, prognostic factors of oral cancer, diagnostic method of oral cancer, and imaging techniques for diagnosis of oral cancer. The search was restricted to articles published in English, with no publication date restriction (last update April, 2013). Review Methods. In this paper, I approach the factors of prognosis of OSCC and the new advances in diagnostic technologies as well. I also reviewed available studies of the tissue fluorescence spectroscopy and other noninvasive diagnostic aids for OSCC. Results. The outcome is greatly influenced by the stage of the disease (especially TNM). Prognosis also depends or varies with tumour primary site, nodal involvement, tumour thickness, and the status of the surgical margins. Conclusion. Tumour diameter is not the most accurate when compared to tumour thickness or depth of invasion, which can be related directly to prognosis. There is a wide agreement on using ultrasound guided fine needle aspiration biopsies in the evaluation of lymph node metastasis.
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Kuribayashi A, Imaizumi A, Tetsumura A, Yoshino N, Kurabayashi T. Magnetic resonance imaging of myoepithelioma in the salivary glands. Oral Radiol 2013; 29:87-91. [DOI: 10.1007/s11282-012-0109-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Extracranial applications of diffusion-weighted (DW) magnetic resonance (MR) imaging are gaining increasing importance, including in head and neck radiology. The main indications for performing DW imaging in this relatively small but challenging region of the body are tissue characterization, nodal staging, therapy monitoring, and early detection of treatment failure by differentiating recurrence from posttherapeutic changes. Lower apparent diffusion coefficients (ADCs) have been reported in the head and neck region of adults and children for most malignant lesions, as compared with ADCs of benign lesions. For nodal staging, DW imaging has shown promise in helping detect lymph node metastases, even in small (subcentimeter) nodes with lower ADCs, as compared with normal or reactive nodes. Follow-up of early response to treatment is reflected in an ADC increase in the primary tumor and nodal metastases; whereas nonresponding lesions tend to reveal only a slight increase or even a decrease in ADC during follow-up. Optimization and standardization of DW imaging technical parameters, comparison of DW images with morphologic images, and increasing experience, however, are prerequisites for successful application of this challenging technique in the evaluation of various head and neck pathologic conditions.
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Affiliation(s)
- Harriet C Thoeny
- Department of Radiology, Neuroradiology and Nuclear Medicine, Inselspital, Freiburgstrasse 10, University of Bern, Bern CH-3010, Switzerland.
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Abstract
While anatomic imaging (CT and MR imaging) of HNC is focused on diagnosing and/or characterizing the disease, defining its local extent, and evaluating distant spread, accurate assessment of the biologic status of the cancer (cellularity, growth rate, response to nonsurgical chemoradiation therapy, and so forth) can be invaluable for prognostication, planning therapy, and follow-up of lesions after therapy. The combination of anatomic and biologic imaging techniques can thus provide a more comprehensive evaluation of the patient. The purpose of this work was to review the present and future clinical applications of advanced biologic imaging techniques in HNC evaluation and management. As part of the biologic imaging array, we discuss MR spectroscopy, diffusion and perfusion MR imaging, CTP, and FDG-PET scanning and conclude with exciting developments that hold promise in assessment of tumor hypoxia and neoangiogenesis.
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Affiliation(s)
- A Srinivasan
- Department of Radiology, Division of Neuroradiology, University of Michigan Health System, Ann Arbor, Michigan 48109, USA.
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Christe A, Waldherr C, Hallett R, Zbaeren P, Thoeny H. MR imaging of parotid tumors: typical lesion characteristics in MR imaging improve discrimination between benign and malignant disease. AJNR Am J Neuroradiol 2011; 32:1202-7. [PMID: 21724574 DOI: 10.3174/ajnr.a2520] [Citation(s) in RCA: 144] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND PURPOSE The surgical approach to parotid tumors is different for benign and malignant neoplasms, but the clinical symptoms do not correlate well with histology. Difficulties in tumor classification also arise in imaging modalities, in which sonography has the lowest and MR imaging, the highest accuracy. The purpose of this study was to review our experience using conventional MR imaging of the neck in the evaluation of parotid tumors and to evaluate which MR imaging findings are best able to predict malignant histology. MATERIALS AND METHODS Eighty-four consecutive patients (43 males, 41 females; median age, 56 years; range, 9-85 years) with parotid gland tumors who underwent MR imaging before surgery were prospectively included in the present study and retrospectively analyzed. Histology was available for all tumors. We analyzed the following MR imaging parameters: signal intensity, contrast enhancement, lesion margins (well-defined versus ill-defined), lesion location (deep/superficial lobe), growth pattern (focal, multifocal, or diffuse), and extension into neighboring structures, perineural spread, and lymphadenopathy. RESULTS The 57 (68%) benign and 27 (32%) malignant tumors consisted of 29 pleomorphic adenomas, 17 Warthin tumors, 11 various benign tumors, 5 mucoepidermoid carcinomas, 3 adenoid cystic carcinomas, 1 acinic cell carcinoma, 1 carcinoma ex pleomorphic adenoma, 9 metastases, and 8 various malignant neoplasms. Specific signs predictive of malignancy were the following: T2 hypointensity of the parotid tumor (P = .048), ill-defined margins (P = .001), diffuse growth (P = .012), infiltration of subcutaneous tissue (P = .0034), and lymphadenopathy (P = .012). CONCLUSIONS Low signal intensity on T2-weighted images and postcontrast ill-defined margins of a parotid tumor are highly suggestive of malignancy.
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Affiliation(s)
- A Christe
- Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital, University of Bern, Bern, Switzerland.
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Lechner Goyault J, Riehm S, Neuville A, Gentine A, Veillon F. Interest of diffusion-weighted and gadolinium-enhanced dynamic MR sequences for the diagnosis of parotid gland tumors. J Neuroradiol 2011; 38:77-89. [DOI: 10.1016/j.neurad.2009.10.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2009] [Accepted: 10/13/2009] [Indexed: 01/05/2023]
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Abstract
The growth of functional and metabolically informative imaging is eclipsing anatomic imaging alone in clinical practice. The recognition that magnetic resonance (MR) and positron emission tomography (PET)-based treatment planning and response assessment are essential components of clinical practice and furthermore offer the potential of quantitative analysis being important. Extracting the greatest benefit from these imaging techniques will require refining the best combinations of multimodality imaging through well-designed clinical trials that use robust image-analysis tools and require substantial computer based infrastructure. Through these changes and enhancements, image-based biomarkers will enhance clinical decision making and accelerate the progress that is made through clinical trial research.
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Affiliation(s)
- John E Bayouth
- Department of Radiation Oncology, University of Iowa, Iowa City, IA 52242, USA.
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Abstract
Extracranial application of diffusion-weighted magnetic resonance imaging (MRI) has gained increasing importance in recent years. As a result of technical advances, this new non-invasive functional technique has also been applied in head and neck radiology for several clinical indications. In cancer imaging, diffusion-weighted MRI can be performed for tumour detection and characterization, monitoring of treatment response as well as the differentiation of recurrence and post-therapeutic changes after radiotherapy. Even for lymph node staging promising results have been reported recently. This review article provides overview of potential applications of diffusion-weighted MRI in head and neck with the main focus on its applications in oncology.
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Affiliation(s)
- Harriet C Thoeny
- Institute of Diagnostic, Interventional and Pediatric Radiology, Inselspital, University of Bern, Freiburgstrasse 10, 3010 Bern, Switzerland.
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Abstract
PURPOSE To evaluate the role of diffusion-weighted magnetic resonance imaging and proton magnetic resonance spectroscopy in diagnosis of different orbital masses and their advantages over conventional magnetic resonance imaging. METHODS The study included 32 patients presenting with proptosis. Every patient was subjected to a clinical examination; conventional MRI "T1 weighted, T2 weighted, and post-contrast T1 weighted if needed;" diffusion-weighted MRI; and proton magnetic resonance spectroscopy. Orbitotomy was performed, the orbital mass was excised, and histopathological examination was performed. RESULTS Diffusion-weighted MRI can be used to differentiate between benign lesions and malignant tumors in 75% of cases; however, overlap occurred in 25% of cases with benign tumors showing restricted diffusion while proton magnetic resonance spectroscopy could differentiate between benign and malignant tumors in 93.7% of cases. CONCLUSION Diffusion-weighted MRI and proton magnetic resonance spectroscopy increased the accuracy of diagnosis of orbital masses through giving in vivo tissue characterization; with magnetic resonance spectroscopy being more accurate.
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Affiliation(s)
- Nader Roshdy
- Mansoura Ophthamic Center, Mansoura University, Mansoura, Egypt
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Bhatia KSS, King AD, Yeung DKW, Mo F, Vlantis AC, Yu KH, Wong JKT, Ahuja AT. Can diffusion-weighted imaging distinguish between normal and squamous cell carcinoma of the palatine tonsil? Br J Radiol 2010; 83:753-8. [PMID: 20647507 DOI: 10.1259/bjr/58331222] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The utility of diffusion-weighted imaging (DWI) in the detection of squamous cell carcinoma (SCC) of the tonsils has not been previously investigated. This preliminary study compared DWI of apparent SCC tonsillar tumours with normal tonsils. DWI of the tonsils was performed in 10 patients with newly diagnosed tonsil SCC that was evident on conventional MRI and in 17 patients undergoing cranial MRI for other indications. Regions of interest (ROI) were drawn around each identifiable tonsil on the apparent diffusion coefficient (ADC) map and the mean ADC value for each tonsil was calculated. ADC values for normal and SCC tonsils were compared using the Mann-Whitney U-test. The median ADC and range (x10(-3) mm(2) s(-1)) were found to be 0.814 and 0.548-1.312, respectively, for normal tonsils compared with 0.933 and 0.789-1.175, respectively, for SCC tonsils. ADC values were significantly higher for SCC tonsils than for normal tonsils (p = 0.009). No SCC tonsil had an ADC less than 0.82 x 10(-3) mm(2) s(-1) compared with 58% of normal tonsils. We conclude that there is a difference in the ADC between normal tonsils and SCC tonsils where the cancer is apparent on conventional MRI. These results are promising, although further studies are now required to determine whether DWI can be used to identify or exclude smaller foci of SCC within tonsils where the cancer is not evident on conventional MRI.
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Affiliation(s)
- K S S Bhatia
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China.
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Roshdy N, Shahin M, Kishk H, El-Khouly S, Mousa A, Elsalekh I. Role of new magnetic resonance imaging modalities in diagnosis of orbital masses: a clinicopathologic correlation. Middle East Afr J Ophthalmol 2010; 17:175-9. [PMID: 20616927 PMCID: PMC2892136 DOI: 10.4103/0974-9233.63077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose: To evaluate the role of diffusion-weighted magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (MRS) in the diagnosis of different orbital masses and their advantages over conventional MRI. Materials and Methods: The study included 20 patients presenting with proptosis. Every patient was subjected to thorough clinical examination, conventional MRI “T1 weighted, T2 weighted, and postcontrast T1 weighted if needed,” diffusion-weighted MRI, and proton MRS. Orbitotomy was performed, the orbital mass was excised, and histopathological examination was performed. Results: Diffusion-weighted MRI could differentiate between benign lesions and malignant tumors in 70% of cases; however, overlap occurred in 30% of cases with benign tumors showing restricted diffusion whereas proton MRS could differentiate between benign and malignant tumors in 90% of cases. Conclusion: Diffusion-weighted MRI and proton MRS can potentially increase the accuracy of diagnosis of orbital masses through in vivo tissue characterization. Magnetic resonance spectroscopy seems to be the more accurate modality.
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Affiliation(s)
- Nader Roshdy
- Mansoura Ophthamic Center, Mansoura University, Mansoura, Egypt
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Abstract
PURPOSE OF REVIEW Diffusion-weighted MRI (DWI) is a noninvasive imaging technique allowing some degree of tissue characterization by showing and quantifying molecular diffusion. Cell size, density and integrity influence the signal intensity seen on diffusion-weighted images. A number of recent reports suggest that this technique may have interesting applications in the evaluation of head and neck cancer, by distinguishing tumoural from nontumoural tissue. RECENT FINDINGS In squamous cell cancer, DWI appears helpful in staging neck nodal disease and in distinguishing radiotherapy-induced tissue changes from persistent or recurrent cancer. DWI may also have prognostic value before and during radiotherapy of head and neck cancer. The technique may also be useful in characterizing thyroid nodules and salivary gland neoplasms. SUMMARY Early evidence suggests that DWI may become a useful tool, complementary to existing imaging techniques, in the evaluation of head and neck malignancies. Further technical improvements and clinical validation are needed.
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King AD, Mo FK, Yu KH, Yeung DK, Zhou H, Bhatia KS, Tse GM, Vlantis AC, Wong JK, Ahuja AT. Squamous cell carcinoma of the head and neck: diffusion-weighted MR imaging for prediction and monitoring of treatment response. Eur Radiol 2010; 20:2213-20. [PMID: 20309553 DOI: 10.1007/s00330-010-1769-8] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Revised: 01/27/2010] [Accepted: 02/24/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To investigate the role of diffusion-weighted imaging (DWI) in predicting and monitoring chemoradiotherapy response in head and neck squamous cell carcinoma (HNSCC). METHODS Diffusion-weighted imaging was performed pre-treatment (n = 50), intra-treatment (n = 41) and post-treatment (n = 20). Apparent diffusion coefficient (ADC) values were correlated with locoregional failure (LF). RESULTS Locoregional failure occurred in 20/50 (40%) patients. A significant correlation was found between LF and post-treatment ADC (p = 0.02) but not pre- or intra-treatment ADC. Serial change in ADC was even more significant (p = 0.00001), using a fall in ADC early (pre- to intra-treatment) or late (intra- to post-treatment) to indicate LF, achieved 100% specificity, 80% sensitivity and 90% accuracy. CONCLUSIONS Single ADC measurements pre- or intra-treatment did not predict response, but ADC post-treatment was a marker for LF. Serial change in ADC was an even stronger marker, when using an early or late treatment fall in ADC to identify LF.
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Abstract
This article reviews the utility of diffusion-weighted imaging (DWI) in the diagnosis, prognosis and monitoring of treatment response in tumors arising in the head and neck region. The apparent diffusion coefficient (ADC) value, determined from DWI, can help in cancer staging and detection of subcentimeter nodal metastasis. The ADC value also discriminates carcinomas from lymphomas, benign lesions from malignant tumors and tumor necrosis from abscesses. Low pretreatment ADC values typically predict a favorable response to chemoradiation therapy. These promising reports indicate the potential of DWI as a potential biomarker for diagnosis and monitoring of treatment response in head and neck cancers. In view of the overlapping ADC values between different salivary gland tumors, care should be taken when interpreting these results and other imaging parameters should be considered for a better diagnosis. Susceptibility and motion-induced artifacts may sometimes degrade DWI image quality; however, novel techniques are being developed to overcome these drawbacks.
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Affiliation(s)
- Sanjeev Chawla
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
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Juan CJ, Chang HC, Hsueh CJ, Liu HS, Huang YC, Chung HW, Chen CY, Kao HW, Huang GS. Salivary Glands: Echo-Planar versus PROPELLER Diffusion-weighted MR Imaging for Assessment of ADCs. Radiology 2009; 253:144-52. [PMID: 19789257 DOI: 10.1148/radiol.2531082228] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Chun-Jung Juan
- Department of Radiology, National Defense Medical Center, Taipei, Taiwan, Republic of China
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Aschenbach R, Basche S, Vogl TJ, Klisch J. Diffusion-weighted imaging and ADC mapping of head-and-neck paragangliomas: initial experience. ACTA ACUST UNITED AC. 2009;19:215-219. [PMID: 19705076 DOI: 10.1007/s00062-009-9004-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2009] [Accepted: 06/02/2009] [Indexed: 12/17/2022]
Abstract
BACKGROUND Paragangliomas are rare, hypervascularized benign tumors. In some cases a clear differentiation of paragangliomas and other entities is impossible. PATIENTS AND METHODS The authors evaluated ten patients with skull base lesions (paraganglioma n = 7, meningioma n = 1, giant cell tumor n = 1, and neurinoma n = 1) in addition to conventional magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI), and calculation of apparent diffusion coefficient (ADC). RESULTS Mean ADC values +/- standard deviation of the paragangliomas were 1.304 +/- 0.257 x 10(-3) mm(2)/s and differed from ADC values of the other jugular fossa tumors with 0.743 +/- 0.108 x 10(-3) mm(2)/s and measurement derived from the cerebellum with 0.802 +/- 0.075 x 10(-3) mm(2)/s. CONCLUSION Due to the difference of ADC values, the authors propose that DWI and ADC mapping could be a promising tool in the diagnostic work-up of paragangliomas.
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Doshi J, Jindal M, Chavda S, Irving R, De R. Diffusion-weighted magnetic resonance imaging: its uses in otolaryngology. J Laryngol Otol 2009; 123:1199-203. [DOI: 10.1017/s0022215109990466] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractOver recent years, there has been an increase in otolaryngology publications concerning diffusion-weighted magnetic resonance imaging. The aims of this review paper are to summarise the basic principles of diffusion-weighted magnetic resonance imaging, and to provide an overview of current otolaryngological applications and areas of research. Diffusion-weighted magnetic resonance imaging is a radiological technique which has shown promising results in various areas of otolaryngology. However, studies of diffusion-weighted magnetic resonance imaging are difficult to compare, as different imaging parameters and techniques have been used. The role of this imaging modality within otolaryngology is yet to be fully elucidated. Diffusion-weighted magnetic resonance imaging may prove to be a useful adjunct in both the pre- and post-operative care of otolaryngology patients.
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Maurer MH, Gartenschläger S, Dietrich C. Giant epithelial-myoepithelial carcinoma of the parotid gland. Clin Imaging 2009; 33:237-9. [PMID: 19411033 DOI: 10.1016/j.clinimag.2008.11.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2008] [Accepted: 11/20/2008] [Indexed: 11/20/2022]
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Habermann CR, Arndt C, Graessner J, Diestel L, Petersen KU, Reitmeier F, Ussmueller JO, Adam G, Jaehne M. Diffusion-weighted echo-planar MR imaging of primary parotid gland tumors: is a prediction of different histologic subtypes possible? AJNR Am J Neuroradiol 2009; 30:591-6. [PMID: 19131405 DOI: 10.3174/ajnr.a1412] [Citation(s) in RCA: 167] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE Our aim was to determine the value of echo-planar diffusion-weighted MR imaging (epiDWI) in differentiating various types of primary parotid gland tumors. MATERIALS AND METHODS One hundred forty-nine consecutive patients with suspected tumors of the parotid gland were examined with an epiDWI sequence by using a 1.5T unit. Image analysis was performed by 2 radiologists independently, and the intraclass correlation coefficient was computed. Histologic diagnosis was obtained in every patient. For comparison of apparent diffusion coefficients (ADCs), a paired 2-tailed Student t test with a Bonferroni correction was used. RESULTS In 136 patients, a primary parotid gland tumor was confirmed by histology. Among the observers, a high correlation was calculated (0.98). ADC values of pleomorphic adenomas were significantly higher than those of all other entities, except for myoepithelial adenomas (P = .054). ADC values of Warthin tumors were different from those of myoepithelial adenomas, lipomas, and salivary duct carcinomas (P < .001, 0.013, and .037, respectively). Mucoepidermoid carcinomas, acinic cell carcinomas, and basal cell adenocarcinomas were not differentiable from Warthin tumors (P = .094, .396, and .604, respectively). CONCLUSION epiDWI has the potential to differentiate pleomorphic adenoma and myoepithelial adenomas from all other examined entities. Due to an overlap not only within the group of benign and malignant lesions but also between groups, diagnoses should not be addressed on the basis of ADC values solely. Therefore, further studies combining DWI, morphologic criteria, and probably other MR imaging techniques seem warranted.
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Affiliation(s)
- C R Habermann
- Department of Diagnostic and Interventional Radiology, Diagnostic Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Yabuuchi H, Matsuo Y, Kamitani T, Setoguchi T, Okafuji T, Soeda H, Sakai S, Hatakenaka M, Nakashima T, Oda Y, Honda H. Parotid Gland Tumors: Can Addition of Diffusion-weighted MR Imaging to Dynamic Contrast-enhanced MR Imaging Improve Diagnostic Accuracy in Characterization? Radiology 2008; 249:909-16. [DOI: 10.1148/radiol.2493072045] [Citation(s) in RCA: 199] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Ries T, Arndt C, Regier M, Graessner J, Cramer MC, Reitmeier F, Jaehne M, Adam G, Habermann CR. Value of apparent diffusion coefficient calculation before and after gustatory stimulation in the diagnosis of acute or chronic parotitis. Eur Radiol 2008; 18:2251-7. [DOI: 10.1007/s00330-008-0995-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2007] [Revised: 02/26/2008] [Accepted: 03/05/2008] [Indexed: 11/25/2022]
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