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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] [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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Wu J, Zhou Z, Wang X, Jin Y, Wang Z, Jin G. Diagnostic performance of elastosonography in the differential diagnosis of benign and malignant salivary gland tumors: A meta-analysis. Front Oncol 2022; 12:954751. [PMID: 36212466 PMCID: PMC9533713 DOI: 10.3389/fonc.2022.954751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/30/2022] [Indexed: 11/21/2022] Open
Abstract
Purpose The clinical practice of elastosonography for the detection of salivary gland tumors is still a controversial issue. The objective of this meta-analysis was to evaluate the effect of elastosonography for the diagnosis of salivary gland tumors and to compare the diagnostic value of elastosonography and conventional ultrasound in the diagnosis of salivary gland tumors. Methods A comprehensive literature search through PubMed, EMBASE, and Cochrane Library was carried out from inception to November 2021. Two researchers independently extracted the data from the enrolled papers using a standard data extraction form. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) were calculated to evaluate the diagnostic performance of elastosonography. The Quality Assessment of Diagnostic Accuracy Studies—2 (QUADAS-2) tool was utilized to evaluate the quality of each included study. Meta-DiSc version 1.4, Review Manager 5.3, and StataSE 15 were used. Results Sixteen studies with a total of 1105 patients with 1146 lesions were included in this meta-analysis. The pooled sensitivity, specificity, PLR, NLR, and DOR of elastosonography for the differentiation between benign and malignant salivary gland tumors were 0.73 (95%CI, 0.66–0.78), 0.64 (95%CI, 0.61–0.67), 2.83 (95%CI, 1.97–4.07), 0.45 (95%CI, 0.32–0.62), and 9.86 (95%CI, 4.49–21.62), respectively, with an AUC of 0.82. Four studies provided data regarding the conventional ultrasound for the differentiation between benign and malignant salivary gland tumors. The pooled sensitivity, specificity, and DOR were 0.62 (95%CI, 0.50–0.73), 0.93 (95%CI, 0.90–0.96), and 25.07 (95%CI, 4.28–146.65), respectively. The meta-regression and subgroup analyses found that assessment methods were associated with significant heterogeneity, and quantitative or semiquantitative elastosonography performed better than the qualitative one. Conclusions Elastosonography showed a limited value for diagnosing malignant salivary gland tumors; it could be considered as a supplementary diagnostic technology to conventional ultrasound, and quantitative or semiquantitative elastosonography was superior to the qualitative one.
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Affiliation(s)
- Jiangfeng Wu
- Department of Ultrasound, Dongyang Hospital of Wenzhou Medical University, Dongyang, China
- *Correspondence: Jiangfeng Wu, ; Zhengping Wang, ; Guilong Jin,
| | - Zhijuan Zhou
- Department of Ultrasound, Tianxiang East Hospital, Yiwu, China
| | - Xiaoyun Wang
- Department of Nephrology, Dongyang Hospital of Wenzhou Medical University, Dongyang, China
| | - Yun Jin
- Department of Ultrasound, Dongyang People’s Hospital, Dongyang, China
| | - Zhengping Wang
- Department of Ultrasound, Dongyang Hospital of Wenzhou Medical University, Dongyang, China
- *Correspondence: Jiangfeng Wu, ; Zhengping Wang, ; Guilong Jin,
| | - Guilong Jin
- Department of Ultrasound, Dongyang Hospital of Wenzhou Medical University, Dongyang, China
- *Correspondence: Jiangfeng Wu, ; Zhengping Wang, ; Guilong Jin,
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Diffusion-weighted imaging with histogram analysis of the apparent diffusion coefficient maps in the diagnosis of parotid tumours. Int J Oral Maxillofac Surg 2021; 51:166-174. [PMID: 33895039 DOI: 10.1016/j.ijom.2021.03.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 03/26/2021] [Accepted: 03/31/2021] [Indexed: 12/18/2022]
Abstract
The aim of this study was to investigate the role of diffusion-weighted imaging (DWI) with histogram analysis of apparent diffusion coefficient (ADC) maps in the characterization of parotid tumours. This prospective study included 39 patients with parotid tumours. All patients underwent magnetic resonance imaging with DWI, and ADC maps were generated. The whole lesion was selected to obtain histogram-related parameters, including the mean (ADCmean), minimum (ADCmin), maximum (ADCmax), skewness, and kurtosis of the ADC. The final diagnosis included pleomorphic adenoma (PA; n=18), Warthin tumour (WT; n=12), and salivary gland malignancy (SGM; n=9). ADCmean (×10-3mm2/s) was 1.93±0.34 for PA, 1.01±0.11 for WT, and 1.26±0.54 for SGM. There was a significant difference in whole lesion ADCmean among the three study groups. Skewness had the best diagnostic performance in differentiating PA from WT (P=0.001; best detected cut-off 0.41, area under the curve (AUC) 0.990) and in discriminating WT from SGM (P=0.03; best detected cut-off 0.74, AUC 0.806). The whole lesion ADCmean value had best diagnostic performance in differentiating PA from SGM (P=0.007; best detected cut-off 1.16×10-3mm2/s, AUC 0.948). In conclusion, histogram analysis of ADC maps may offer added value in the differentiation of parotid tumours.
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Stoia S, Băciuț G, Lenghel M, Badea R, Csutak C, Rusu GM, Băciuț M, Tamaș T, Boțan E, Armencea G, Bran S, Dinu C. Cross-sectional imaging and cytologic investigations in the preoperative diagnosis of parotid gland tumors - An updated literature review. Bosn J Basic Med Sci 2021; 21:19-32. [PMID: 32893758 PMCID: PMC7861630 DOI: 10.17305/bjbms.2020.5028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 09/01/2020] [Indexed: 02/07/2023] Open
Abstract
An accurate preoperative diagnosis of parotid tumors is essential for the selection and planning of surgical treatment. Various modern cross-sectional imaging and cytologic investigations can support the differential diagnosis of parotid tumors. The aim of this study was to achieve a comprehensive and updated review of modern imaging and cytologic investigations used in parotid tumor diagnosis, based on the latest literature data. This literature review could serve as a guide for clinicians in selecting different types of investigations for the preoperative differential diagnosis of parotid tumors. Magnetic resonance imaging (MRI) with its dynamic and advanced sequences is the first-line imaging investigation used in differentiating parotid tumors. Computed tomography (CT) and positron emission tomography (PET)-CT provide limited indications in differentiating parotid tumors. Fine needle aspiration biopsy and core needle biopsy can contribute with satisfactory results to the cytological diagnosis of parotid tumors. Dynamic MRI with its dynamic contrast-enhanced and diffusion-weighted sequences provides the best accuracy for the preoperative differential diagnosis of parotid tumors. CT allows the best evaluation of bone invasion, being useful when MRI cannot be performed, and PET-CT has value in the follow-up of cancer patients. The dual cytological and imaging approach is the safest method for an accurate differential diagnosis of parotid tumors.
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Affiliation(s)
- Sebastian Stoia
- Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Grigore Băciuț
- Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Manuela Lenghel
- Department of Radiology, Faculty of Medicine, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Radu Badea
- Department of Medical Imaging, Faculty of Medicine, "Iuliu Hațieganu" University of Medicine and Pharmacy, Department of Medical Imaging, "Prof. Dr. Octavian Fodor" Regional Institute of Gastroenterology, Cluj-Napoca, Romania
| | - Csaba Csutak
- Department of Radiology, Faculty of Medicine, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Georgeta Mihaela Rusu
- Department of Radiology, Faculty of Medicine, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihaela Băciuț
- Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Tiberiu Tamaș
- Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Emil Boțan
- Department of Pathology, Emergency County Hospital, Cluj-Napoca, Romania
| | - Gabriel Armencea
- Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Simion Bran
- Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cristian Dinu
- Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
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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] [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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Abdel Razek AAK, Helmy EM. Differentiation malignant from benign parotid tumors in children with diffusion-weighted MR imaging. Oral Radiol 2020; 37:463-468. [PMID: 32885384 DOI: 10.1007/s11282-020-00479-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/24/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE To differentiate pediatric solid malignant from the benign parotid tumors with diffusion-weighted MR imaging (DWI). MATERIALS AND METHODS A retrospective study comprising 38 children with parotid tumors (21 boys and 17 girls aged from 2 months to 17 years) was conducted using (DWI) of the parotid gland. Apparent diffusion coefficient (ADC) maps were generated. The ADC value of the parotid tumors was calculated. RESULTS The mean ADC value of malignant parotid tumors (1.08 ± 0.1, 1.04 ± 0.1 × 10-3mm2/s) was significantly lower [P = 0.001] than that of benign lesions (1.69 ± 0.2, 1.72 ± 0.3 × 10-3mm2/s). A threshold of ADC of 1.40, 1.33 × 10-3mm2/s was used for differentiating malignant parotid tumors from benign lesions and led to the best results of the area under the curve of 0.940, 0.929, accuracy of 86, 89%, sensitivity of 94, 94%, specificity of 80, 85%, negative predictive value of 94.1, 94.4%, and positive predictive value of 81, 85%. There was insignificant difference in ADC values of malignant lesions (P = 0.23, 0.30) as well as within benign lesions (P = 0.25, 0.08). CONCLUSION DWI is an innovative anticipating imaging technique that can be used in the differentiation of pediatric solid malignant parotid tumors from benign lesions.
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Affiliation(s)
| | - Eman Mohamed Helmy
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, 13551, Egypt
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7
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Nix JS, Rooper LM. Navigating small biopsies of salivary gland tumors: a pattern-based approach. J Am Soc Cytopathol 2020; 9:369-382. [PMID: 32660844 DOI: 10.1016/j.jasc.2020.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/20/2020] [Accepted: 06/05/2020] [Indexed: 12/15/2022]
Abstract
Diagnosis of salivary gland tumors on small biopsy can be difficult because of overlapping morphology, limited tissue availability, and technical artifact. Although a specific diagnosis is not feasible in all cases, a cautious and thoughtful approach to the differential diagnosis and a keen awareness of clinical consequences can facilitate the most complete and useful classification possible. In this review, we present a general strategy for the evaluation of small salivary biopsies, including consideration of clinical and radiographic information, systematic assessment of histologic patterns, and judicious use of immunohistochemistry and molecular studies. We then focus on the distinctive differential diagnoses raised by 6 specific histologic patterns: tubular and cribriform architecture, squamous differentiation, mucin and other secretions, high-grade cytology, epithelial and lymphoid elements, and oncocytic features. Throughout this systematic and pattern-based approach, we focus on practical and cost-effective strategies to overcome the most common diagnostic challenges in limited material.
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MESH Headings
- Artifacts
- Biomarkers, Tumor/metabolism
- Biopsy/methods
- Carcinoma, Adenoid Cystic/diagnosis
- Carcinoma, Adenoid Cystic/metabolism
- Carcinoma, Adenoid Cystic/pathology
- Carcinoma, Mucoepidermoid/diagnosis
- Carcinoma, Mucoepidermoid/metabolism
- Carcinoma, Mucoepidermoid/pathology
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/metabolism
- Carcinoma, Squamous Cell/pathology
- Diagnosis, Differential
- Humans
- Immunohistochemistry/methods
- Mucins/biosynthesis
- Salivary Gland Neoplasms/diagnosis
- Salivary Gland Neoplasms/metabolism
- Salivary Gland Neoplasms/pathology
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Affiliation(s)
- J Stephen Nix
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Lisa M Rooper
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
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8
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Patella F, Sansone M, Franceschelli G, Tofanelli L, Petrillo M, Fusco M, Nicolino GM, Buccimazza G, Fusco R, Gopalakrishnan V, Pesapane F, Biglioli F, Cariati M. Quantification of heterogeneity to classify benign parotid tumors: a feasibility study on most frequent histotypes. Future Oncol 2020; 16:763-778. [PMID: 32250169 DOI: 10.2217/fon-2019-0736] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Aim: To differentiate Warthin tumors (WTs) and pleomorphic adenomas (PAs) measuring heterogeneity of intravoxel incoherent motion (IVIM) and dynamic-contrast enhanced-magnetic resonance imaging biomarkers. Methods: Volumes of interest were traced on 18 WT and 18 PA in 25 patients. For each IVIM and dynamic-contrast enhanced biomarker, histogram parameters were calculated and then compared using the Wilcoxon-signed-rank test. Receiver operating characteristic curves and multivariate analysis were employed to identify the parameters and their pairs with the best accuracy. Results: Most of the biomarkers exhibited significant difference (p < 0.05) between PA and WT for histogram parameters. Time to peak median and skewness, and D* median and entropy showed the highest area under the curve. No meaningful improvement of accuracy was obtained using two features. Conclusion: IVIM and dynamic-contrast enhanced histogram descriptors may help in the classification of WT and PA.
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Affiliation(s)
- Francesca Patella
- Università degli Studi di Milano, Postgraduate School in Radiodiagnostics Milano, Lombardia, Italy.,Diagnostic & Interventional Radiology Service, San Paolo Hospital, Milan, Italy
| | - Mario Sansone
- Department of Electrical Engineering & Information Technologies, University 'Federico II' of Naples, Via Claudio, Naples, Italy
| | | | - Laura Tofanelli
- Università degli Studi di Milano, Postgraduate School in Radiodiagnostics Milano, Lombardia, Italy
| | - Mario Petrillo
- Diagnostic & Interventional Radiology Service, San Paolo Hospital, Milan, Italy
| | - Massimo Fusco
- Università degli Studi di Milano, Postgraduate School in Radiodiagnostics Milano, Lombardia, Italy
| | - Gabriele Maria Nicolino
- Università degli Studi di Milano, Postgraduate School in Radiodiagnostics Milano, Lombardia, Italy
| | - Giorgio Buccimazza
- Università degli Studi di Milano, Postgraduate School in Radiodiagnostics Milano, Lombardia, Italy
| | - Roberta Fusco
- Radiology Unit, 'Dipartimento di supporto ai percorsi oncologici Area Diagnostica, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale', Via Mariano Semmola, Naples, Italy
| | | | - Filippo Pesapane
- Università degli Studi di Milano, Postgraduate School in Radiodiagnostics Milano, Lombardia, Italy
| | - Federico Biglioli
- Maxillofacial Surgery Unit, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy
| | - Maurizio Cariati
- Diagnostic & Interventional Radiology Service, San Paolo Hospital, Milan, Italy
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El Kininy W, Roddy D, Davy S, Roman E, O'Keane V, O'Hanlon E, Barry D, Stassen LFA. Magnetic resonance diffusion weighted imaging using constrained spherical deconvolution-based tractography of the extracranial course of the facial nerve. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:e44-e56. [PMID: 32033932 DOI: 10.1016/j.oooo.2019.12.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 12/07/2019] [Accepted: 12/20/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To evaluate the accuracy of magnetic resonance diffusion weighted imaging (DWI) featuring constrained spherical deconvolution-based tractography in tracking the extracranial course of the facial nerve to provide a reliable facial nerve map to facilitate well-tolerated and effective tumor resection. STUDY DESIGN Magnetic resonance DWI was conducted on 2 parotid-healthy cadaveric patients with various protocols to identify the best representation of the extracranial facial nerve tract. This was subsequently correlated to dissection of the facial nerves to ascertain anatomic validation. These protocols were applied to 2 live, parotid-healthy patients to assess feasibility of in vivo facial nerve tract identification. RESULTS Correlations between imaged tracts and the anatomic course of the extracranial facial nerve were identified to an accuracy of 1 mm. The main trunk and bifurcation tracts were identified on imaging. Fractional anisometry values in cadaveric and live patients were within the range expected for the facial nerve within the parotid gland. CONCLUSIONS Our results indicated the potential for accurate 3-dimensional visualization of the extracranial course of the facial nerve, which could have diagnostic implications in differentiating benign from malignant tumors and, crucially, neural involvement. Preoperative planning applications of DWI could help in planning surgical approaches and providing focused counseling.
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Affiliation(s)
- Walid El Kininy
- Trinity College Dublin - M.D. post graduate doctorate and Specialist Registrar, Oral & Maxillofacial Surgery, Kent Surrey Sussex Deanery, UK.
| | - Darren Roddy
- Neuroscience Institute, Trinity College Dublin, Dublin, Ireland
| | - Shane Davy
- Department of Anatomy, Trinity College Dublin
| | | | | | - Erik O'Hanlon
- Senior postdoctoral research fellow, Neuroscience, Trinity College Dublin
| | - Denis Barry
- Assistant professor and M.D. supervisor, Department of Anatomy, Trinity College Dublin
| | - Leo F A Stassen
- Professor and chair of Oral/Maxillofacial Surgery and M.D. supervisor, Trinity College Dublin
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10
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Razek AAKA. Multi-parametric MR imaging using pseudo-continuous arterial-spin labeling and diffusion-weighted MR imaging in differentiating subtypes of parotid tumors. Magn Reson Imaging 2019; 63:55-59. [DOI: 10.1016/j.mri.2019.08.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 08/05/2019] [Accepted: 08/15/2019] [Indexed: 12/26/2022]
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Abdel Razek AK, Elkhamary S, Nada N. Correlation of apparent diffusion coefficient with histopathological parameters of salivary gland cancer. Int J Oral Maxillofac Surg 2019; 48:995-1000. [DOI: 10.1016/j.ijom.2019.03.897] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 01/31/2019] [Accepted: 03/18/2019] [Indexed: 12/18/2022]
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12
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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] [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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A comparison of conventional and diffusion-weighted magnetic resonance imaging in the diagnosis of sialadenitis and pleomorphic adenoma. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 127:451-457. [PMID: 30497909 DOI: 10.1016/j.oooo.2018.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 10/02/2018] [Accepted: 10/12/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The aim of this study was to compare the efficacy of conventional magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) in correctly identifying the presence of disease in the major salivary glands and correctly distinguish sialadenitis from pleomorphic adenoma. STUDY DESIGN Twenty-one patients diagnosed with unilateral sialadenitis or pleomorphic adenoma were selected. The nonaffected contralateral glands were also analyzed. T1- and T2-weighted MRI and DWI were obtained using spin-echo pulse sequences with a 1.5 Tesla MRI device. The diagnostic performance of 3 observers was evaluated for detection of salivary gland alterations and differentiation between sialadenitis and pleomorphic adenoma based on evaluation of MRI in comparison with DWI. RESULTS Intra-and interobserver reliability ranged from 0.86 to 0.94. DWI demonstrated greater sensitivity and accuracy values compared with MRI for both detection of disease and differentiation of sialadenitis from pleomorphic adenoma, with specificity values that were greater than or equal to those of MRI. DWI yielded significantly higher diagnostic odds ratios compared with MRI for both identification of disease and differentiation between lesions. CONCLUSIONS DWI demonstrated better diagnostic performance in the detection of alterations in the salivary glands and in differentiating between sialadenitis and pleomorphic adenoma compared with conventional T1 and T2-weighted MRI.
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Abstract
This article reviews the role of routine and advanced diffusion imaging modules of the salivary glands. Routine and advanced diffusion imaging modules have a role in differentiation of malignant from benign salivary gland tumors, characterization of some benign salivary gland tumors, and staging of salivary gland cancer. The role of advanced diffusion modules in patients with salivary gland cancer after surgery, radiation therapy, or radioiodine therapy is discussed. Advanced diffusion imaging modules can help in diagnosis and staging of Sjögren syndrome.
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Zheng N, Li R, Liu W, Shao S, Jiang S. The diagnostic value of combining conventional, diffusion-weighted imaging and dynamic contrast-enhanced MRI for salivary gland tumors. Br J Radiol 2018; 91:20170707. [PMID: 29902075 DOI: 10.1259/bjr.20170707] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To determine the diagnostic value of combining conventional MRI, diffusion-weighted imaging (DWI) and dynamic contrast enhanced MRI (DCE-MRI) in salivary gland tumors. METHODS 45 patients with salivary gland tumors were evaluated with conventional MRI, DWI and DCE-MRI prior to surgery and confirmed by pathologic findings. The apparent diffusion coefficient (ADC) was calculated from DWI that was obtained with a factor of 0 and 1000 s mm-2. A time-intensity curve (TIC) was obtained from DCE-MRI. RESULTS In conventional MRI, benign tumors often showed well-defined and clear margins, malignant tumors showed irregular margins or infiltration into the surrounding tissue. There were significant differences with regard to the ADC values between pleomorphic adenoma (1.72 ± 0.29 × 10-3 mm2 s-1) and malignant tumors (0.95 ± 0.09 × 10-3 mm2 s-1, p < 0.05) and between adenolymphoma (0.74 ± 0.05 × 10-3 mm2 s-1) and malignant tumors (p < 0.05). However, there was no significant differences in term of the ADC values between benign tumors (1.33 ± 0.52×10-3 mm2 s-1) and malignant tumors. DCE-MRI showed benign tumors with A-type, B-type and D-type of TICs, and the malignant tumors with C-type TICs. A combination of all of these parameters yielded sensitivity, specificity, accuracy, and positive and negative predictive values of 90%, 97%, 95%, 90 and 97%, respectively. CONCLUSION An evaluation combining MRI morphologic findings and functional MRI (ADCs and TIC) appears to be useful in differentiating benign from malignant tumors in salivary gland tumors. Advances in knowledge: The study firstly dealt with the combination of conventional MRI, DWI-MRI with DCE-MRI in salivary gland tumors.
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Affiliation(s)
- Ning Zheng
- 1 Department of Radiology, Jining NO.1 People's Hospital , Jining , China
| | - Rui Li
- 1 Department of Radiology, Jining NO.1 People's Hospital , Jining , China
| | - Wenjuan Liu
- 1 Department of Radiology, Jining NO.1 People's Hospital , Jining , China
| | - Shuo Shao
- 1 Department of Radiology, Jining NO.1 People's Hospital , Jining , China
| | - Shan Jiang
- 1 Department of Radiology, Jining NO.1 People's Hospital , Jining , China
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Abdel Razek AAK, Mukherji SK. State-of-the-Art Imaging of Salivary Gland Tumors. Neuroimaging Clin N Am 2018; 28:303-317. [DOI: 10.1016/j.nic.2018.01.009] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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17
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Atkinson C, Fuller J, Huang B. Cross-Sectional Imaging Techniques and Normal Anatomy of the Salivary Glands. Neuroimaging Clin N Am 2018; 28:137-158. [DOI: 10.1016/j.nic.2018.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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18
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Rouchy RC, Attyé A, Medici M, Renard F, Kastler A, Grand S, Tropres I, Righini CA, Krainik A. Facial nerve tractography: A new tool for the detection of perineural spread in parotid cancers. Eur Radiol 2018; 28:3861-3871. [PMID: 29633003 DOI: 10.1007/s00330-018-5318-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 12/29/2017] [Accepted: 01/09/2018] [Indexed: 02/08/2023]
Abstract
OBJECTIVES To determine whether facial nerve MR tractography is useful in detecting PeriNeural Spread in parotid cancers. METHODS Forty-five participants were enrolled. Thirty patients with surgically managed parotid tumors (15 malignant, 15 benign) were compared with 15 healthy volunteers. All of them had undergone 3T-MRI with diffusion acquisition and post-processing constrained spherical deconvolution-based tractography. Parameters of diffusion-weighted sequences were b-value 1,000 s/mm2, 32 directions. Two radiologists performed a blinded visual reading of tractographic maps and graded the facial nerve average pathlength and fractional anisotropy (FA). We also compared diagnostic accuracy of tractography with morphological MRI sequences to detect PeriNeural Spread. Non-parametric methods were used. RESULTS Average pathlength was significantly higher in cases with PeriNeural Spread (39.86 mm [Quartile1: 36.27; Quartile3: 51.19]) versus cases without (16.23 mm [12.90; 24.90]), p<0.001. The threshold above which there was a significant association with PeriNeural Spread was set at 27.36 mm (Se: 100%; Sp: 84%; AUC: 0.96, 95% CI 0.904-1). There were no significant differences in FA between groups. Tractography map visual analyses directly displayed PeriNeural Spread in distal neural ramifications with sensitivity of 75%, versus 50% using morphological sequences. CONCLUSIONS Tractography could be used to identify facial nerve PeriNeural Spread by parotid cancers. KEY POINTS • Tractography could detect facial nerve PeriNeural Spread in parotid cancers. • The average pathlength parameter is increased in case of PeriNeural Spread. • Tractography could map PeriNeural Spread more precisely than conventional imaging.
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Affiliation(s)
- René-Charles Rouchy
- Department of Neuroradiology and MRI, Grenoble Alpes University Hospital - SFR RMN Neurosciences, F-38043, Grenoble, Cedex 9, France. .,University of Grenoble Alpes, IRMaGe, F-38000, Grenoble, France.
| | - Arnaud Attyé
- Department of Neuroradiology and MRI, Grenoble Alpes University Hospital - SFR RMN Neurosciences, F-38043, Grenoble, Cedex 9, France.,University of Grenoble Alpes, IRMaGe, F-38000, Grenoble, France
| | - Maud Medici
- Clinical Investigation Centre 1406 - Innovative Technology, National Institute of Health and Medical Research, Grenoble, France.,Public Health Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Félix Renard
- University of Grenoble Alpes, IRMaGe, F-38000, Grenoble, France
| | - Adrian Kastler
- Department of Neuroradiology and MRI, Grenoble Alpes University Hospital - SFR RMN Neurosciences, F-38043, Grenoble, Cedex 9, France.,University of Grenoble Alpes, IRMaGe, F-38000, Grenoble, France
| | - Sylvie Grand
- Department of Neuroradiology and MRI, Grenoble Alpes University Hospital - SFR RMN Neurosciences, F-38043, Grenoble, Cedex 9, France.,University of Grenoble Alpes, IRMaGe, F-38000, Grenoble, France
| | - Irène Tropres
- University of Grenoble Alpes, IRMaGe, F-38000, Grenoble, France.,IRMaGe, Inserm US 17, CNRS UMS 3552, Grenoble, France
| | | | - Alexandre Krainik
- Department of Neuroradiology and MRI, Grenoble Alpes University Hospital - SFR RMN Neurosciences, F-38043, Grenoble, Cedex 9, France.,University of Grenoble Alpes, IRMaGe, F-38000, Grenoble, France
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Razek AAKA. Prediction of malignancy of submandibular gland tumors with apparent diffusion coefficient. Oral Radiol 2017; 35:11-15. [DOI: 10.1007/s11282-017-0311-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 12/18/2017] [Indexed: 12/13/2022]
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