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Xu Z, Huang L, Yang Y, Cai Z, Chen M, Lu R, Ouyang Y, Hong Z, Huang W, Xu Z. Discriminating atypical parotid carcinoma and pleomorphic adenoma utilizing extracellular volume fraction and arterial enhancement fraction derived from contrast-enhanced CT imaging: A multicenter study. Cancer Med 2024; 13:e7407. [PMID: 38899534 PMCID: PMC11187748 DOI: 10.1002/cam4.7407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 06/03/2024] [Accepted: 06/07/2024] [Indexed: 06/21/2024] Open
Abstract
OBJECTIVES To investigate the added value of extracellular volume fraction (ECV) and arterial enhancement fraction (AEF) derived from enhanced CT to conventional image and clinical features for differentiating between pleomorphic adenoma (PA) and atypical parotid adenocarcinoma (PCA) pre-operation. METHODS From January 2010 to October 2023, a total of 187 cases of parotid tumors were recruited, and divided into training cohort (102 PAs and 51 PCAs) and testing cohort (24 PAs and 10 atypical PCAs). Clinical and CT image features of tumor were assessed. Both enhanced CT-derived ECV and AEF were calculated. Univariate analysis identified variables with statistically significant differences between the two subgroups in the training cohort. Multivariate logistic regression analysis with the forward variable selection method was used to build four models (clinical model, clinical model+ECV, clinical model+AEF, and combined model). Diagnostic performances were evaluated using receiver operating characteristic (ROC) curve analyses. Delong's test compared model differences, and calibration curve and decision curve analysis (DCA) assessed calibration and clinical application. RESULTS Age and boundary were chosen to build clinical model, and to construct its ROC curve. Amalgamating the clinical model, ECV, and AEF to establish a combined model demonstrated superior diagnostic effectiveness compared to the clinical model in both the training and test cohorts (AUC = 0.888, 0.867). There was a significant statistical difference between the combined model and the clinical model in the training cohort (p = 0.0145). CONCLUSIONS ECV and AEF are helpful in differentiating PA and atypical PCA, and integrating clinical and CT image features can further improve the diagnostic performance.
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Affiliation(s)
- Zhen‐Yu Xu
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Lin‐Wen Huang
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Yun‐Jun Yang
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Zhi‐Ping Cai
- Department of RadiologyShunde Hospital, Southern Medical University (The First People's Hospital of Shunde)FoshanChina
| | - Mei‐Lin Chen
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Rui‐Liang Lu
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Yong‐Xi Ouyang
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Zhen‐Kai Hong
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Wei‐Jun Huang
- Department of UltrasoundThe First People's Hospital of FoshanFoshanChina
| | - Zhi‐Feng Xu
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
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Varoquaux A, Fakhry N, Baujat B, Verillaud B, Jegoux F, Barry B, Chabrillac E, Vergez S, Terroir-Cassou-Mounat M. Diagnostic imaging of salivary gland cancers: REFCOR recommendations by the formal consensus method. Eur Ann Otorhinolaryngol Head Neck Dis 2024; 141:27-31. [PMID: 38036312 DOI: 10.1016/j.anorl.2023.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
OBJECTIVE To define the indications for each imaging modality in the screening, characterization, extension and follow-up of salivary gland tumors. MATERIAL AND METHODS The French Network of Rare Head and Neck Tumors (REFCOR) formed a steering group who drafted a narrative review of the literature published on Medline and proposed recommendations. The level of adherence to the recommendations was then assessed by a rating group, according to the formal consensus method. RESULTS If a swelling of a salivary gland is palpable for 3 weeks, an ultrasound scan is recommended to confirm a tumoral lesion and rule out differential diagnoses. For a salivary gland tumor, MRI is recommended with diffusion-weighted and dynamic contrast-enhanced techniques. In the case of histologically proven malignancy or a highly suspicious lesion, a CT scan of the neck and chest is recommended to assess the tumor, lymph nodes and metastases. FDG-PET is not currently recommended in routine clinical practice for initial diagnosis, assessment of extension, evaluation of response to treatment, staging of recurrence, or follow-up of salivary gland tumors. CONCLUSION Assessing salivary tumors is based on MRI. Extension assessment is based on neck and chest CT.
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Affiliation(s)
- A Varoquaux
- Département d'Imagerie Médicale, Hôpital La Conception, AP-HM, Aix-Marseille Univ, Marseille, France
| | - N Fakhry
- Département d'ORL et Chirurgie Cervico-Faciale, Hôpital La Conception, AP-HM, Aix-Marseille Univ, Marseille, France.
| | - B Baujat
- Département d'ORL et Chirurgie Cervico-Faciale, Hôpital Tenon, AP-HP, Sorbonne Université, Paris, France
| | - B Verillaud
- Département d'ORL et de Chirurgie Cervico-Faciale, Hôpital Lariboisière, AP-HP, Inserm U1141, Université Paris Cité, Paris, France
| | - F Jegoux
- Département d'ORL et Chirurgie Cervico-Faciale, CHU de Rennes, Rennes, France
| | - B Barry
- Département d'ORL et Chirurgie Cervico-Faciale, Hôpital Bichat, AP-HP, Paris, France
| | - E Chabrillac
- Département de Chirurgie, Institut Universitaire du Cancer Toulouse - Oncopole, Toulouse, France
| | - S Vergez
- Département de Chirurgie, Institut Universitaire du Cancer Toulouse - Oncopole, Toulouse, France; Département de Chirurgie ORL et Cervico-Faciale, CHU de Toulouse-Larrey, Université Toulouse III Paul Sabatier, Toulouse, France
| | - M Terroir-Cassou-Mounat
- Département de Médecine Nucléaire, Institut Universitaire du Cancer Toulouse - Oncopole, Toulouse, France
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Graber M, Cadour F, El Ahmadi AA, Khati I, Del Grande J, Chagnaud C, Fakhry N, Guye M, Varoquaux A. Adding automated decision-tree models to multiparametric MRI for parotid tumours improves clinical performance. Eur J Radiol 2023; 166:110999. [PMID: 37499477 DOI: 10.1016/j.ejrad.2023.110999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/06/2023] [Accepted: 07/19/2023] [Indexed: 07/29/2023]
Abstract
PURPOSE Therapeutic management of parotid gland tumours depends on their histological type. To aid its characterisation, we sought to develop automated decision-tree models based on multiparametric magnetic resonance imaging (MRI) parameters and to evaluate their added diagnostic value compared with morphological sequences. METHODS 206 MRIs from 206 patients with histologically proven parotid gland tumours were included from January 2009 to January 2018. Multiparametric MRI findings (including parameters derived from diffusion-weighted imaging [DWI] and dynamic contrast-enhanced [DCE]) were used to build predictive classification and regression tree (CART) models for each histological type. All MRIs were read twice: first, based on morphological sequence findings only, and second, with the addition of multiparametric sequences and CART findings. The diagnostic performance between these two readings was compared using ROC curves. RESULTS Compared to morphological sequences alone, the addition of multiparametric analysis significantly increased the diagnostic performance for all histological types (p < 0.001 to p = 0.011), except for lymphomas, where the increase was not significant (AUC 1.00 vs. 0.99, p = 0.066). ADCmean was the best parameter to identify pleomorphic adenomas, carcinomas and lymphomas with respective cut-offs of 1.292 × 10-3 mm2/s, 1.181 × 10-3 mm2/s and 0.611 × 10-3 mm2/s, respectively. × 10-3 mm2/s. The mean extracellular-extravascular space coefficient was the best parameter to Warthin tumours from the others, with a cut-off of 0.07. CONCLUSIONS The addition of decision tree prediction models based on multiparametric sequences improves the non-invasive diagnostic performance of parotid gland tumours. ADC and extracellular-extravascular space coefficient are the two best parameters for decision making.
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Affiliation(s)
- Matthieu Graber
- Department of Radiology, Conception Hospital, Aix-Marseille Univ, Marseille, France
| | - Farah Cadour
- Department of Radiology, Conception Hospital, Aix-Marseille Univ, Marseille, France
| | - Ahmed Ali El Ahmadi
- Department of Radiology, Conception Hospital, Aix-Marseille Univ, Marseille, France
| | - Idir Khati
- Department of Radiology, Conception Hospital, Aix-Marseille Univ, Marseille, France
| | - Jean Del Grande
- Department of Anatomopathology, Timone Hospital, Aix-Marseille Univ, Marseille, France
| | - Christophe Chagnaud
- Department of Radiology, Conception Hospital, Aix-Marseille Univ, Marseille, France; CNRS-Aix-Marseille University, CRMBM (UMR73-39), Marseille, France
| | - Nicolas Fakhry
- Department of Head and Neck Surgery, Conception Hospital, Aix-Marseille Univ, Marseille, France
| | - Maxime Guye
- CNRS-Aix-Marseille University, CRMBM (UMR73-39), Marseille, France
| | - Arthur Varoquaux
- Department of Radiology, Conception Hospital, Aix-Marseille Univ, Marseille, France; CNRS-Aix-Marseille University, CRMBM (UMR73-39), Marseille, France.
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Muntean DD, Dudea SM, Băciuț M, Dinu C, Stoia S, Solomon C, Csaba C, Rusu GM, Lenghel LM. The Role of an MRI-Based Radiomic Signature in Predicting Malignancy of Parotid Gland Tumors. Cancers (Basel) 2023; 15:3319. [PMID: 37444429 PMCID: PMC10340186 DOI: 10.3390/cancers15133319] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/11/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
The aim of this study was to assess the ability of MRI radiomic features to differentiate between benign parotid gland tumors (BPGT) and malignant parotid gland tumors (MPGT). This retrospective study included 93 patients who underwent MRI examinations of the head and neck region (78 patients presenting unique PGT, while 15 patients presented double PGT). A total of 108 PGT with histological confirmation were eligible for the radiomic analysis and were assigned to a training group (n = 83; 58 BPGT; 25 MPGT) and a testing group (n = 25; 16 BPGT; 9 MPGT). The radiomic features were extracted from 3D segmentations of the PGT on the T2-weighted and fat-saturated, contrast-enhanced T1-weighted images. Following feature reduction techniques, including LASSO regression analysis, a radiomic signature (RS) was built with five radiomic features. The RS presented a good diagnostic performance in differentiating between PGT, achieving an area under the curve (AUC) of 0.852 (p < 0.001) in the training set and 0.786 (p = 0.017) in the testing set. In both datasets, the RS proved to have lower values in the BPGT group as compared to MPGT group (p < 0.001 and p = 0.023, respectively). The multivariate analysis revealed that RS was independently associated with PGT malignancy, together with the ill-defined margin pattern (p = 0.031, p = 0.001, respectively). The complex model, using clinical data, MRI features and the RS, presented a higher diagnostic performance (AUC of 0.976) in comparison to the RS alone. MRI-based radiomic features could be considered potential additional imaging biomarkers able to discriminate between benign and malignant parotid gland tumors.
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Affiliation(s)
- Delia Doris Muntean
- Department of Radiology, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.D.M.); (S.M.D.); (C.C.); (G.M.R.); (L.M.L.)
| | - Sorin Marian Dudea
- Department of Radiology, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.D.M.); (S.M.D.); (C.C.); (G.M.R.); (L.M.L.)
| | - Mihaela Băciuț
- Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (M.B.); (C.D.); (S.S.)
| | - Cristian Dinu
- Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (M.B.); (C.D.); (S.S.)
| | - Sebastian Stoia
- Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (M.B.); (C.D.); (S.S.)
| | - Carolina Solomon
- Department of Radiology, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.D.M.); (S.M.D.); (C.C.); (G.M.R.); (L.M.L.)
| | - Csutak Csaba
- Department of Radiology, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.D.M.); (S.M.D.); (C.C.); (G.M.R.); (L.M.L.)
| | - Georgeta Mihaela Rusu
- Department of Radiology, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.D.M.); (S.M.D.); (C.C.); (G.M.R.); (L.M.L.)
| | - Lavinia Manuela Lenghel
- Department of Radiology, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.D.M.); (S.M.D.); (C.C.); (G.M.R.); (L.M.L.)
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Santos LAR, Brito MTV. Minor Salivary Gland Polymorphous Adenocarcinoma With Local Recurrence After Seven Years: A Case Report. Cureus 2023; 15:e40112. [PMID: 37425574 PMCID: PMC10329255 DOI: 10.7759/cureus.40112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2023] [Indexed: 07/11/2023] Open
Abstract
Polymorphous adenocarcinoma is a rare neoplasm of the minor salivary glands with an indolent behavior. Here, we report and describe the computed tomography (CT) and magnetic resonance imaging (MRI) of polymorphic adenocarcinoma in a 69-year-old patient who presented with local recurrence seven years after the initial treatment. On contrast CT, the primary lesion appeared heterogeneous and invaded the pterygopalatine fossa and the sphenopalatine foramen. The recurrent lesion on MRI showed a hypointense signal on the T1-weighted sequence, a hyperintense signal on the T2-weighted sequence, and heterogeneous enhancement with contrast. The patient underwent a new surgery for lesion resection and is currently under clinical and radiological follow-up. It is recommended to follow patients for at least 15 years after diagnosis, as local recurrences can occur up to 10 years after the initial treatment.
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Gökçe E, Beyhan M. Diagnostic efficacy of diffusion-weighted imaging and semiquantitative and quantitative dynamic contrast-enhanced magnetic resonance imaging in salivary gland tumors. World J Radiol 2023; 15:20-31. [PMID: 36721673 PMCID: PMC9884336 DOI: 10.4329/wjr.v15.i1.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/15/2022] [Accepted: 12/14/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Increased use of functional magnetic resonance imaging (MRI) methods such as diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) MRI consisting of sequential contrast series, allows us to obtain more information on the microstructure, cellularity, interstitial distance, and vascularity of tumors, which has increased the discrimination power for benign and malignant salivary gland tumors (SGTs). In the last few years, quantitative DCE MRI data containing T1 perfusion parameters (Ktrans, Kep and Ve), were reported to contribute to the differentiation of benign or malignant subtypes in SGTs.
AIM To evaluate the diagnostic efficacy of DWI and semiquantitative and quantitative perfusion MRI parameters in SGTs.
METHODS Diffusion MRI [apparent diffusion coefficient (ADC) value] with a 1.5 T MR machine, semiquantitative perfusion MRI [time intensity curve (TIC) pattern], and quantitative perfusion MRI examinations (Ktrans, Kep and Ve) of 73 tumors in 67 patients with histopathological diagnosis performed from 2017 to 2021 were retrospectively evaluated. In the ADC value and semiquantitative perfusion MRI measurements, cystic components of the tumors were not considered, and the region of interest (ROI) was manually placed through the widest axial section of the tumor. TIC patterns were divided into four groups: Type A = Tpeak > 120 s; type B = Tpeak ≤ 120 s, washout ratio (WR) ≥ 30%; type C = Tpeak ≤ 120 s, WR < 30%; and type D = flat TIC. For the quantitative perfusion MRI analysis, a 3D ROI was placed in the largest solid component of the tumor, and the Ktrans, Kep and Ve values were automatically generated.
RESULTS The majority of SGTs were located in the parotid glands (86.3%). Of all the SGTs, 68.5% were benign and 31.5% were malignant. Significant differences were found for ADC values among pleomorphic adenomas (PMAs), Warthin's tumors (WTs), and malignant tumors (MTs) (P < 0.001). PMAs had type A and WTs had type B TIC pattern while the vast majority of MTs and other benign tumors (OBTs) (54.5% and 45.5%, respectively) displayed type C TIC pattern. PMAs showed no washout, while the highest mean WR was observed in WTs (59% ± 11%). Ktrans values of PMAs, WTs, OBTs, and MTs were not significantly different. Kep values of PMAs and WTs were significantly different from those of OBTs and MTs. Mean Ve value of WTs was significantly different from those of PMAs, OBTs, and MTs (P < 0.001).
CONCLUSION The use of quantitative DCE parameters along with diffusion MRI and semiquantitative contrast-enhanced MRI in SGTs could improve the diagnostic accuracy.
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Affiliation(s)
- Erkan Gökçe
- Department of Radiology, Tokat Gaziosmanpasa University, Faculty of Medicine, Tokat 60100, Turkey
| | - Murat Beyhan
- Department of Radiology, Tokat Gaziosmanpasa University, Faculty of Medicine, Tokat 60100, Turkey
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Gökçe E, Beyhan M. Advanced magnetic resonance imaging findings in salivary gland tumors. World J Radiol 2022; 14:256-271. [PMID: 36160835 PMCID: PMC9453317 DOI: 10.4329/wjr.v14.i8.256] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/22/2022] [Accepted: 08/07/2022] [Indexed: 02/08/2023] Open
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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Elsholtz FHJ, Reiter R, Marticorena Garcia SR, Braun J, Sack I, Hamm B, Schaafs LA. Multifrequency magnetic resonance elastography-based tomoelastography of the parotid glands-feasibility and reference values. Dentomaxillofac Radiol 2022; 51:20210337. [PMID: 34558305 PMCID: PMC8693321 DOI: 10.1259/dmfr.20210337] [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] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES Accurate radiological differentiation of parotid tumors remains challenging despite recent technical advances in quantitative medical imaging. Multifrequency magnetic resonance elastography (MRE) could provide additional information on viscoelastic properties of normal and abnormal biological tissues. This study investigates the feasibility of MRE of the parotid glands in healthy participants and provides first reference values. METHODS 20 healthy participants underwent multifrequency MRE of both parotid glands at 3 Tesla. Shear waves at frequencies of 25, 30, 40, and 50 Hz were introduced into the participants' heads through the occiput using pressurized-air actuators. Shear wave speed (SWS) and loss angle of the shear modulus (φ) were reconstructed by tomoelastography post-processing as surrogate parameters for tissue stiffness and viscosity or fluidity. 10 participants underwent repeated MRE to determine test-retest reliability based on intraclass correlation coefficients. RESULTS All MRE datasets acquired could be included in the analysis. Mean SWS was 0.97 ± 0.13 m/s, and mean φ was 0.59 ± 0.05 rad, each for both sides combined and without notable lateral difference (p = 0.88/0.87). Test-retest reliability was good for SWS (ICC = 0.84 for both sides/ICC = 0.77 for the right side/ICC = 0.79 for the left side) and good to excellent for φ(ICC = 0.94/0.86/0.90). CONCLUSIONS Multifrequency MRE of the parotid glands is feasible and reliable. This technique, therefore, is a promising method for investigating the viscoelastic properties of salivary gland tumors in future studies.
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Affiliation(s)
- Fabian Henry Jürgen Elsholtz
- Department of Radiology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Berlin, Germany
| | | | - Stephan Rodrigo Marticorena Garcia
- Department of Radiology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Charité Mitte, Berlin, Germany
| | - Jürgen Braun
- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Medical Informatics, Campus Charité Mitte, Berlin, Germany
| | - Ingolf Sack
- Department of Radiology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Charité Mitte, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Lars-Arne Schaafs
- Department of Radiology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Berlin, Germany
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9
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Huang N, Chen Y, She D, Xing Z, Chen T, Cao D. Diffusion kurtosis imaging and dynamic contrast-enhanced MRI for the differentiation of parotid gland tumors. Eur Radiol 2021; 32:2748-2759. [PMID: 34642805 PMCID: PMC8921043 DOI: 10.1007/s00330-021-08312-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 08/24/2021] [Accepted: 08/30/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To assess the usefulness of combined diffusion kurtosis imaging (DKI) and dynamic contrast-enhanced MRI (DCE-MRI) in the differentiation of parotid gland tumors. METHODS Seventy patients with 80 parotid gland tumors who underwent DKI and DCE-MRI were retrospectively enrolled and divided into four groups: pleomorphic adenomas (PAs), Warthin tumors (WTs), other benign tumors (OBTs), and malignant tumors (MTs). DCE-MRI and DKI quantitative parameters were measured. The Kruskal-Wallis H test and post hoc test with Bonferroni correction and ROC curve were used for statistical analysis. RESULTS WTs demonstrated the highest Kep value (median 1.89, interquartile range [1.46-2.31] min-1) but lowest Ve value (0.20, [0.15-0.25]) compared with PAs (Kep, 0.34 [0.21-0.55] min-1; Ve, 0.36 [0.24-0.43]), OBTs (Kep, 1.22 [0.27-1.67] min-1; Ve, 0.28 [0.25-0.41]), and MTs (Kep, 0.71 [0.50-1.23] min-1; Ve, 0.35 [0.26-0.45]) (all p < .05). MTs had the lower D value (1.10, [0.88-1.29] × 10-3 mm2/s) compared with PAs (1.81, [1.60-2.20] × 10-3 mm2/s) and OBTs (1.57, [1.32-1.89] × 10-3 mm2/s) (both p < .05). PAs had the lower Ktrans value (0.12, [0.07-0.18] min-1) compared with OBTs (0.28, [0.11-0.50] min-1) (p < .05). The cutoff values of combined Kep and Ve, D, and Ktrans to distinguish WTs, MTs, and PAs sequentially were 1.06 min-1, 0.28, 1.46 × 10-3 mm2/s, and 0.21 min-1, respectively (accuracy, 89% [71/80], 91% [73/80], 78% [62/80], respectively). CONCLUSION The combined use of DKI and DCE-MRI may help differentiate parotid gland tumors. KEY POINTS • The combined use of DKI and DCE-MRI could facilitate the understanding of the pathophysiological characteristics of parotid gland tumors. • A stepwise diagnostic diagram based on the combined use of DCE-MRI parameters and the diffusion coefficient is helpful for accurate preoperative diagnosis in parotid gland tumors and may further facilitate the clinical management of patients.
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Affiliation(s)
- Nan Huang
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China
| | - Yu Chen
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China
| | - Dejun She
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China
| | - Zhen Xing
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China
| | - Tanhui Chen
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China
| | - Dairong Cao
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China. .,Department of Radiology, Fujian Key Laboratory of Precision Medicine for Cancer, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, Fujian, China. .,Key Laboratory of Radiation Biology of Fujian Higher Education Institutions, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, Fujian, China.
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10
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Liu F, Zhao M, Lu S, Kang L. Study on the Value of DCE-MRI in Differentiating Glossitis and Tongue Cancer and the Intratumour Heterogeneity. Cancer Manag Res 2021; 13:6925-6934. [PMID: 34526818 PMCID: PMC8436779 DOI: 10.2147/cmar.s315418] [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: 04/21/2021] [Accepted: 08/11/2021] [Indexed: 12/02/2022] Open
Abstract
Objective DCE-MRI is an imaging technique that reflects the blood perfusion status of the tissue’s microcirculation. The purpose of this article is to explore the clinical value of dynamic contrast-enhanced (DCE)-MRI in distinguishing benign and malignant tongue lesions and the internal heterogeneity of a tumour. Methods The patients were divided into a tongue cancer group (22 patients) and a glossitis group (7 patients) based on the pathology results. All of the patients underwent DCE-MRI examination. Results The results of this study showed that the volume transfer constant (Ktrans), rate constant (Kep), contrast enhancement ratio (CER) and initial area under the gadolinium contrast agent concentration time curve (IAUGG) values of the tongue cancer group were significantly higher than those of the glossitis group, and the difference was statistically significant (P < 0.05). However, the extravascular extracellular volume fraction (Ve), fractional plasma volume (fPV), maximum slope (MaxSlope), and bolus arrival time (BAT) values measured by DCE-MRI in the tongue cancer group were not significantly different from those in the glossitis group (P > 0.05). The results of this study showed that the Ktrans, Kep, and IAUGG values measured by DCE-MRI had a good ability to distinguish tongue inflammation from tumours and Ktrans threshold of 0.484 has the best discriminative ability among them. The mean Ktrans values of stage I–II lesions were significantly higher than that of stage III–IV lesion (p = 0.045). Conclusion DCE-MRI is effective in distinguishing between benign and malignant tongue lesions and the internal heterogeneity of the tumour; it is worth following up in a larger study. Clinical Registration Number Research registry 6393.
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Affiliation(s)
- Fenghai Liu
- Department of Magnetic Resonance Imaging, Cangzhou Central Hospital, Cangzhou, Hebei Province, 061001, People's Republic of China
| | - Meng Zhao
- Department of Magnetic Resonance Imaging, Cangzhou Central Hospital, Cangzhou, Hebei Province, 061001, People's Republic of China
| | - Shan Lu
- Department of Magnetic Resonance Imaging, Cangzhou Central Hospital, Cangzhou, Hebei Province, 061001, People's Republic of China
| | - Liqing Kang
- Department of Magnetic Resonance Imaging, Cangzhou Central Hospital, Cangzhou, Hebei Province, 061001, People's Republic of China
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11
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Geiger JL, Ismaila N, Beadle B, Caudell JJ, Chau N, Deschler D, Glastonbury C, Kaufman M, Lamarre E, Lau HY, Licitra L, Moore MG, Rodriguez C, Roshal A, Seethala R, Swiecicki P, Ha P. Management of Salivary Gland Malignancy: ASCO Guideline. J Clin Oncol 2021; 39:1909-1941. [PMID: 33900808 DOI: 10.1200/jco.21.00449] [Citation(s) in RCA: 170] [Impact Index Per Article: 56.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To provide evidence-based recommendations for practicing physicians and other healthcare providers on the management of salivary gland malignancy. METHODS ASCO convened an Expert Panel of medical oncology, surgical oncology, radiation oncology, neuroradiology, pathology, and patient advocacy experts to conduct a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 2000 through 2020. Outcomes of interest included survival, diagnostic accuracy, disease recurrence, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. RESULTS The literature search identified 293 relevant studies to inform the evidence base for this guideline. Six main clinical questions were addressed, which included subquestions on preoperative evaluations, surgical diagnostic and therapeutic procedures, appropriate radiotherapy techniques, the role of systemic therapy, and follow-up evaluations. RECOMMENDATIONS When possible, evidence-based recommendations were developed to address the diagnosis and appropriate preoperative evaluations for patients with a salivary gland malignancy, therapeutic procedures, and appropriate treatment options in various salivary gland histologies.Additional information is available at www.asco.org/head-neck-cancer-guidelines.
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Affiliation(s)
| | | | | | | | | | | | | | - Marnie Kaufman
- Adenoid Cystic Carcinoma Research Foundation, Needham, MA
| | | | | | - Lisa Licitra
- Istituto Nazionale Tumori, Milan, Italy.,University of Milan, Milan, Italy
| | | | | | | | | | | | - Patrick Ha
- University of California San Francisco, San Francisco, CA
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12
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Maraghelli D, Pietragalla M, Cordopatri C, Nardi C, Peired AJ, Maggiore G, Colagrande S. Magnetic resonance imaging of salivary gland tumours: Key findings for imaging characterisation. Eur J Radiol 2021; 139:109716. [PMID: 33866123 DOI: 10.1016/j.ejrad.2021.109716] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 04/01/2021] [Accepted: 04/09/2021] [Indexed: 12/22/2022]
Abstract
Salivary gland tumours are rare, representing only 3% of all head and neck neoplasms, with the parotid gland being the most common site (80 %). The risk of malignancy is inversely proportional to the size of the gland: lesions arising in the sublingual or minor salivary glands are more likely to be malignant, whereas parotid gland neoplasms are mostly benign. Fine needle aspiration cytology and core needle biopsy are considered the most accurate modalities for the diagnosis of a salivary gland neoplasm; however, they are not always conclusive due to procedural sampling errors and for the presence of a cytological / histological overlap between benign and malignant tumours. Moreover, they cannot be easily performed for parotid deep portion localisation. The role of magnetic resonance imaging (MRI) is growing and advanced techniques (diffusion-weighted and dynamic contrast-enhanced perfusion-weighted imaging) can provide useful additional information for the assessment of salivary gland neoplasms. The aim of this review is to present the main MRI and clinical features of salivary gland tumours to improve their comprehensive evaluation and characterisation.
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Affiliation(s)
- Davide Maraghelli
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, Careggi University Hospital, Largo Brambilla 3, Florence, 50134, Italy.
| | - Michele Pietragalla
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, Careggi University Hospital, Largo Brambilla 3, Florence, 50134, Italy.
| | - Cesare Cordopatri
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, Careggi University Hospital, Largo Brambilla 3, Florence, 50134, Italy.
| | - Cosimo Nardi
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, Careggi University Hospital, Largo Brambilla 3, Florence, 50134, Italy.
| | - Anna Julie Peired
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, Careggi University Hospital, Largo Brambilla 3, Florence, 50134, Italy.
| | - Giandomenico Maggiore
- Department of Otorhinolaryngology, Careggi University Hospital, Largo Brambilla 3, Florence, 50134, Italy.
| | - Stefano Colagrande
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, Careggi University Hospital, Largo Brambilla 3, Florence, 50134, Italy.
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13
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Shao S, Zheng N, Mao N, Xue X, Cui J, Gao P, Wang B. A triple-classification radiomics model for the differentiation of pleomorphic adenoma, Warthin tumour, and malignant salivary gland tumours on the basis of diffusion-weighted imaging. Clin Radiol 2021; 76:472.e11-472.e18. [PMID: 33752882 DOI: 10.1016/j.crad.2020.10.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 10/02/2020] [Indexed: 01/08/2023]
Abstract
AIM To develop and validate a triple-classification radiomics model for the preoperative differentiation of pleomorphic adenoma (PA), Warthin tumour (WT), and malignant salivary gland tumour (MSGT) based on diffusion-weighted imaging (DWI). MATERIALS AND METHODS Data from 217 patients with histopathologically confirmed salivary gland tumours (100 PAs, 68 WTs, and 49 MSGTs) from January 2015 to March 2019 were analysed retrospectively and divided into a training set (n=173), and a validation set (n=44). A total of 396 radiomic features were extracted from the DWI of all patients. Analysis of variance (ANOVA) and least absolute shrinkage and selection operator (LASSO) regression were used to select radiomic features, which were then constructed using three classification models, namely, logistic regression method (LR), support vector machine (SVM), and K-nearest neighbor (KNN). The diagnostic performance of the radiomics model was quantified by the receiver operating characteristic (ROC) curve and area under the ROC curve (AUC) of the training and validation data sets. RESULTS The 20 most valuable features were investigated based on the LASSO regression. LR and SVM methods exhibited better diagnostic ability than KNN for multiclass classification. LR and SVM had the best performance and yielded the AUC values of 0.857 and 0.824, respectively, in the training data set and the AUC values of 0.932 and 0.912, respectively, in the validation data set of MSGT diagnosis. CONCLUSION DWI-based triple-classification radiomics model has predictive value in distinguishing PA, WT, and MSGT, which can be used for preoperative auxiliary diagnosis in clinical practice.
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Affiliation(s)
- S Shao
- Department of Radiology, Jining No. 1 People's Hospital, Jining, Shandong, 272011, PR China
| | - N Zheng
- Department of Radiology, Jining No. 1 People's Hospital, Jining, Shandong, 272011, PR China
| | - N Mao
- Department of Radiology, Yantai Yuhuangding Hospital, The Affiliated Hospital of Qingdao University, Yantai, 264000, Shandong, PR China
| | - X Xue
- Department of Radiology, Jining No. 1 People's Hospital, Jining, Shandong, 272011, PR China
| | - J Cui
- Huiying Medical Technology Co., Ltd., Beijing, 100192, PR China
| | - P Gao
- Department of Radiology, Jining No. 1 People's Hospital, Jining, Shandong, 272011, PR China.
| | - B Wang
- Medical Imaging Research Institute, Binzhou Medical University, Yantai, 264003, Shandong, PR China.
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14
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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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15
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EL-Adalany MA, Mousa AEM, EL-Metwally D. RETRACTED ARTICLE: The diagnostic value of combined dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging (DWI) in characterization of parotid gland tumors. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2020. [DOI: 10.1186/s43055-020-00237-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Abstract
Background
MRI is considered to be the imaging modality of choice in preoperative diagnosis of parotid gland tumors and differentiating benign from malignant ones. Recently, functional MR imaging sequences including dynamic contrast-enhanced magnetic resonance imaging (DCE- MRI) and diffusion-weighted imaging (DWI) have significantly contributed to the diagnosis of head and neck masses. The purpose of this study was to evaluate the diagnostic value of combined DCE-MRI and DWI in characterization of parotid gland tumors.
Results
There was significant difference between benign and malignant parotid gland tumors as regard the type of time intensity curve (TIC) (P < 0.001). There was significant difference between pleomorphic adenoma (PMA) and malignant parotid gland tumors (MT) as regard mean ADC value (P = 0.046) and TTP (P = 0.002). There was no significant difference between Warthin’s tumor (WT) and malignant parotid gland tumors as regard the ADC value and TTP (P > 0.5); on the other hand, WT usually have high WR when compared with MT (P = 0.004). Combined use of DCE-MRI and DWI had 100% sensitivity, 90.5% specificity, and 93.3% accuracy in differentiating benign from malignant parotid gland tumors.
Conclusion
Combined use of DCE-MRI and DWI could result in high sensitivity, specificity, and diagnostic accuracy in characterization of parotid gland tumors.
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16
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Zhang S, Gu H, Yuan Y, Ren J, Zhang Z, Tao X. Multiparametric Magnetic Resonance Imaging Features That Predict Treatment Response to Endovascular Sclerotherapy in Craniofacial Venous Malformations. J Oral Maxillofac Surg 2020; 79:845-853. [PMID: 33160925 DOI: 10.1016/j.joms.2020.09.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 09/27/2020] [Accepted: 09/29/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Craniofacial venous malformations (VMs) cause severe psychological and physiological burden to patients, and treatment is meaningful only when the benefits of treatment outweigh the risks. Therefore, it is very important to predict the treatment response before treatment. This study was performed to explore the value of multiparametric magnetic resonance imaging for predicting treatment response to endovascular sclerotherapy in VMs. MATERIALS AND METHODS We designed and implemented a case-control study and enrolled a sample from patients with VM treated by endovascular sclerotherapy at our hospital from January 2014 to January 2018. The primary predictor variables were pretreatment volume (prevolume), lesion classification, phleboliths, initial slope of increase (ISI), gender, age, and sclerosants. The primary outcome variable was treatment response (positive response or negative response). Descriptive, univariate and multivariate binary logistic regressions, and Firth's penalized maximum likelihood estimate were computed to measure the association between predictor variables and treatment response. The level of statistical significance was set at a P value less than or equal to .05. RESULTS The sample was composed of 42 patients with a median age of 17.50 years, and 33.3% were males. There were 27 and 15 patients in the positive and negative response groups, respectively. There were significant differences between the 2 groups for ISI (adjusted odds ratio [OR], 2.184; P = .0268; 95% confidence interval [95% CI], 1.094 to 4.360), lesion classification (adjusted OR, 9.072; P = .0226; 95% CI, 1.363 to 60.400), and prevolume (adjusted OR, 1.020; P = .0268; 95% CI, 1.002 to 1.038). The cutoff point for prevolume and ISI was 40.42 cm3 and 2.61. CONCLUSIONS Multiparametric magnetic resonance imaging could provide an approach for predicting treatment response in craniofacial VMs. When the prevolume was greater than 40.42 cm3, ISI was greater than 2.61, and the classification was infiltrating type, the response to sclerotherapy was negative.
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Affiliation(s)
- Shaoting Zhang
- Resident, Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, and Department of Radiology, Changhai Hospital, Shanghai, China
| | - Hao Gu
- Resident, Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Yuan
- Professor, Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiliang Ren
- Professor, Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zimin Zhang
- Professor, Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaofeng Tao
- Professor, Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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17
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Tang M, Huang R, Chen J, Sheng M, Zhang Z, Xing J, Guo L, Li Y. Clinical value of high-resolution dynamic contrast-enhanced (DCE) MRI in diagnosis of cutaneous squamous cell carcinoma. Skin Res Technol 2020; 27:511-520. [PMID: 33141995 DOI: 10.1111/srt.12978] [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] [Received: 06/24/2020] [Accepted: 09/07/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND While uncomplicated cases of skin squamous cell carcinoma (cSCC) can be treated with surgery topical therapy alone, more objective and non-invasive examination methods are needed to guide clinicians to make more detailed biopsy and surgical plans for lesions with atypical or subcutaneous growth. High-resolution magnetic resonance imaging (HR-MRI) is a novel skin imaging method. MATERIALS AND METHODS Prospective collection of 19 patients with clinically suspected cSCC. All patients underwent high-resolution DCE-MRI using a 70-mm microscopy coil before operation. The imaging features and results of surgical pathology were recorded. Ktrans , Kep , Ve values, and the time-signal curve (TIC) types were determined using DCE images. RESULTS 16 cases of cSCC, 3 cases of acanthoma. The subcutaneous invasion of all lesions was clearly displayed, of which 8 lesions invaded the subcutaneous fat layer, 5 invaded the muscle layer, 1 invaded the periosteum, 2 invaded the cap fascia, and the layer of all lesions invasion judged by HR-MR imaging was consistent with the postoperative pathology. The main manifestations of cSCC were ill-defined margin, obvious inhomogeneous enhancement, higher perfusion parameters value and type-III TIC, while acanthoma showed well-defined and type-I TIC. Some imaging findings (such as boundary, enhancement) and DCE perfusion parameters of the two groups overlap. CONCLUSION High-resolution DCE-MRI can fully and directly display the subcutaneous invasion of cSCC, and more work needs to be done to prove its value. Next, we will expand the sample size, and further explore its value in the differential diagnosis and prognosis evaluation of cSCC from acanthoma or other skin tumors.
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Affiliation(s)
- Mengxiao Tang
- Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou, P.R. China
| | - Renjun Huang
- Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou, P.R. China
| | - Jianhua Chen
- Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou, P.R. China
| | - Meiying Sheng
- Department of Burn and Plastic Surgery, the First Affiliated Hospital of Soochow University, Suzhou, P.R. China
| | | | - Jianming Xing
- Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou, P.R. China
| | - Lingchuan Guo
- Department of Pathology, the First Affiliated Hospital of Soochow University, Suzhou, P.R. China
| | - Yonggang Li
- Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou, P.R. China
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Abstract
Primary Sjögren's syndrome (pSS) is an autoimmune disease, which involves salivary glands (SG) and extra glandular organs. Today, Sjögren's patients' diagnosis is based on classification criteria taking into account five objective tests, including histology, immunology, two ophthalmological tests, and salivary flow evaluation. To date, the challenge is to find the right imaging tool for diagnosis, follow up, and prognosis of pSS. The objective of this review is to describe as to what are these imaging modalities and particularly the place and validity of salivary glands ultrasonography (SGUS) in the diagnosis and follow-up strategy of patients with suspected pSS. Moreover, new noninvasive tools are emerging, including elastography, a new ultrasonography technique that provides an estimate of tissue elasticity, MRI, MR sialography, and 18 fluorodeoxyglucose-positron emission tomography. Although new imaging opportunities are available, SGUS should be the first-line choice in pSS because of its accessibility, feasibility over time, and sensitivity to change.
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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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20
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Norris CD, Quick SE, Parker JG, Koontz NA. Diffusion MR Imaging in the Head and Neck: Principles and Applications. Neuroimaging Clin N Am 2020; 30:261-282. [PMID: 32600630 DOI: 10.1016/j.nic.2020.04.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Diffusion imaging is a functional MR imaging tool that creates tissue contrast representative of the random, microscopic translational motion of water molecules within human body tissues. Long considered a cornerstone MR imaging sequence for brain imaging, diffusion-weighted imaging (DWI) increasingly is used for head and neck imaging. This review reports the current state of diffusion techniques for head and neck imaging, including conventional DWI, DWI trace with apparent diffusion coefficient map, diffusion tensor imaging, intravoxel incoherent motion, and diffusion kurtosis imaging. This article describes background physics, reports supportive evidence and potential pitfalls, highlights technical advances, and details practical clinical applications.
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Affiliation(s)
- Carrie D Norris
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 North University Boulevard, Room 0663, Indianapolis, IN 46202, USA. https://twitter.com/CarrieDNorrisMD
| | - Sandra E Quick
- Department of Radiology, Richard L. Roudebush VA Medical Center, 1481 West 10th Street, Indianapolis, IN 46202, USA
| | - Jason G Parker
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 North University Boulevard, Room 0663, Indianapolis, IN 46202, USA
| | - Nicholas A Koontz
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 North University Boulevard, Room 0663, Indianapolis, IN 46202, USA; Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
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21
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Zhai J, Qi A, Zhang Y, Jiao L, Liu Y, Shou S. Bioinformatics Analysis for Multiple Gene Expression Profiles in Sepsis. Med Sci Monit 2020; 26:e920818. [PMID: 32280132 PMCID: PMC7171431 DOI: 10.12659/msm.920818] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background This work aimed to screen key biomarkers related to sepsis progression by bioinformatics analyses. Material/Methods The microarray datasets of blood and neutrophils from patients with sepsis or septic shock were downloaded from Gene Expression Omnibus database. Then, differentially expressed genes (DEGs) from 4 groups (sepsis versus normal blood samples; septic shock versus normal blood samples; sepsis neutrophils versus normal controls and septic shock neutrophils versus controls) were respectively identified followed by functional analyses. Subsequently, protein–protein network was constructed, and key functional sub-modules were extracted. Finally, receiver operating characteristic analysis was conducted to evaluate diagnostic values of key genes. Results There were 2082 DEGs between blood samples of sepsis patients and controls, 2079 DEGs between blood samples of septic shock patients and healthy individuals, 6590 DEGs between neutrophils from sepsis and controls, and 1056 DEGs between neutrophils from septic shock patients and normal controls. Functional analysis showed that numerous DEGs were significantly enriched in ribosome-related pathway, cell cycle, and neutrophil activation involved in immune response. In addition, TRIM25 and MYC acted as hub genes in protein–protein interaction (PPI) analyses of DEGs from microarray datasets of blood samples. Moreover, MYC (AUC=0.912) and TRIM25 (AUC=0.843) had great diagnostic values for discriminating septic shock blood samples and normal controls. RNF4 was a hub gene from PPI analyses based on datasets from neutrophils and RNF4 (AUC=0.909) was capable of distinguishing neutrophil samples from septic shock samples and controls. Conclusions Our findings identified several key genes and pathways related to sepsis development.
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Affiliation(s)
- Jianhua Zhai
- Department of Emergency, Tianjin Medical University General Hospital, Tianjin, China (mainland)
| | - Anlong Qi
- Department of Emergency, Tianjin Medical University General Hospital, Tianjin, China (mainland)
| | - Yan Zhang
- Department of Emergency, Tianjin Medical University General Hospital, Tianjin, China (mainland)
| | - Lina Jiao
- Department of Emergency, Tianjin Medical University General Hospital, Tianjin, China (mainland)
| | - Yancun Liu
- Department of Emergency, Tianjin Medical University General Hospital, Tianjin, China (mainland)
| | - Songtao Shou
- Department of Emergency, Tianjin Medical University General Hospital, Tianjin, China (mainland)
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22
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Nada A, Hady D, Youssef A, Mahmoud E, Assad RE. Accuracy of combined quantitative diffusion-weighted MRI and routine contrast-enhanced MRI in discrimination of benign and malignant salivary gland tumors. Neuroradiol J 2020; 33:216-223. [PMID: 32223516 DOI: 10.1177/1971400920913973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Preoperative imaging of salivary gland tumors is important for predicting and differentiating benign from malignant tumors, and for aiding management planning. We aimed to investigate the accuracy of combined quantitative diffusion-weighted magnetic resonance imaging (MRI) and routine contrast-enhanced MRI in the evaluation of salivary gland tumors and the differentiation of benign from malignant tumors. RESULTS This study included 51 patients with a total of 16 benign and 35 malignant lesions that were detected by histopathological analysis. There was a statistically significant difference between the apparent diffusion coefficient values (ADC) of malignant and benign lesions (0.69 ± 0.22 × 10-3 mm2/s and 1.39 ± 0.52 × 10-3 mm2/s respectively). The optimal cut-off ADC value was 1.08 with 75% specificity and 97% sensitivity. The routine contrast-enhanced MRI had predicted benign and malignant tumors with 65% sensitivity and 44% specificity. The sensitivity and specificity were greatly increased when quantitative diffusion-weighted MRI was combined with routine contrast-enhanced MRI: 100%, and 88% respectively. A receiver operating curve was generated. The area under curve was 0.88 (p < 0.001, 95% CI: 0.76-0.99). CONCLUSION Combined quantitative diffusion-weighted MRI with ADC measurements and routine contrast-enhanced magnetic resonance imaging are helpful tools for the evaluation of salivary gland tumors and help differentiate benign from malignant lesions.
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Affiliation(s)
- Ayman Nada
- Radiology Department, University of Missouri Columbia, USA
| | - Dina Hady
- Diagnostic and Interventional Radiology Department, National Cancer Institute, Cairo University, Egypt
| | - Ayda Youssef
- Diagnostic and Interventional Radiology Department, National Cancer Institute, Cairo University, Egypt
| | - Esmat Mahmoud
- Diagnostic and Interventional Radiology Department, National Cancer Institute, Cairo University, Egypt
| | - Ramy Edward Assad
- Kasr Alainy Medical School, Faculty of Medicine, Cairo University, Egypt
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23
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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: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [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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24
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Shao S, Mao N, Liu W, Cui J, Xue X, Cheng J, Zheng N, Wang B. Epithelial salivary gland tumors: Utility of radiomics analysis based on diffusion-weighted imaging for differentiation of benign from malignant tumors. JOURNAL OF X-RAY SCIENCE AND TECHNOLOGY 2020; 28:799-808. [PMID: 32538891 DOI: 10.3233/xst-190632] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To evaluate the utility of radiomics analysis for differentiating benign and malignant epithelial salivary gland tumors on diffusion-weighted imaging (DWI). METHODS A retrospective dataset involving 218 and 51 patients with histology-confirmed benign and malignant epithelial salivary gland tumors was used in this study. A total of 396 radiomic features were extracted from the DW images. Analysis of variance (ANOVA) and least-absolute shrinkage and selection operator regression (LASSO) were used to select optimal radiomic features. The selected features were used to build three classification models namely, logistic regression method (LR), support vector machine (SVM), and K-nearest neighbor (KNN) by using a five-fold cross validation strategy on the training dataset. The diagnostic performance of each classification model was quantified by receiver operating characteristic (ROC) curve and area under the ROC curve (AUC) in the training and validation datasets. RESULTS Eight most valuable features were selected by LASSO. LR and SVM models yielded optimally diagnostic performance. In the training dataset, LR and SVM yielded AUC values of 0.886 and 0.893 via five-fold cross validation, respectively, while KNN model showed relatively lower AUC (0.796). In the testing dataset, a similar result was found, where AUC values for LR, SVM, and KNN were 0.876, 0.870, and 0.791, respectively. CONCLUSIONS Classification models based on optimally selected radiomics features computed from DW images present a promising predictive value in distinguishing benign and malignant epithelial salivary gland tumors and thus have potential to be used for preoperative auxiliary diagnosis.
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Affiliation(s)
- Shuo Shao
- Shandong Medical Imaging Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Department of Radiology, Jining No. 1 People's Hospital, Jining, Shandong, China
| | - Ning Mao
- Department of Radiology, Yantai Yuhuangding Hospital, the Affiliated Hospital of Qingdao University, Yantai, Shandong, China
| | - Wenjuan Liu
- Department of Radiology, Jining No. 1 People's Hospital, Jining, Shandong, China
| | - Jingjing Cui
- Huiying Medical Technology Co., Ltd. Beijing, China
| | - Xiaoli Xue
- Department of Radiology, Jining No. 1 People's Hospital, Jining, Shandong, China
| | - Jingfeng Cheng
- Department of Radiology, Jining No. 1 People's Hospital, Jining, Shandong, China
| | - Ning Zheng
- Department of Radiology, Jining No. 1 People's Hospital, Jining, Shandong, China
| | - Bin Wang
- Medical Imaging Research Institute, Binzhou Medical University, Yantai, Shandong, China
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