A Multiparametric Analysis Combining DCE-MRI- and IVIM -Derived Parameters to Improve Differentiation of Parotid Tumors: A Pilot Study

Abstract

Aim: To evaluate dynamic contrast-enhanced (DCE)-MRI and diffusion weighted (DW)-MRI diagnostic value to differentiate Warthin tumors (WT) by pleomorphic adenomas (PA). Materials & methods: Seven WT and seven PA were examined. DCE- and DW-MRI parameters were extracted from volumes of interest; volume of interest-based averages and standard deviations were calculated. Statistical analysis included: linear discriminant analysis, receiver operating characteristic curves, sensitivity and specificity. Results: No single feature was able to differentiate WT by PA (p > 0.05); linear discriminant analysis analysis showed that a combination of all features or combinations of feature pairs (namely: K^trans(std) & f(std), K^trans(std) & D(std), k_ep(std) & D(std), MRE(av) & TTP(av)) might achieve sensitivity (SENS), specificity (SPEC) = 100%, with a slight reduction after cross-validation analysis (SENS = 0.875; SPEC = 1). Conclusion: Although preliminary and not conclusive, our results suggest that differentiation between WT and PA is possible through a multiparametric approach based on combination of DCE- and DW-MRI parameters.

Keywords::

• DCE-MRI
• DW-MRI
• extended Tofts–Kermode model
• intravoxel incoherent motionparotid tumors
• pleomorphic adenoma
• Warthin tumors

Conception and design of the study was done by F Patella, M Petrillo, G Franceschelli, M Sansone and R Fusco. Administrative support was given by G Carrafiello. Provision of the study materials or patients was done by AM Saibene and F Biglioli. Collection and assembly of data was done by F Patella. Data analysis and interpretation was done by F Patella, M Petrillo, M Sansone and R Fusco. All the authors helped in writing the manuscript. Final approval of manuscript was given by all the authors.

Acknowledgements

The authors thank AF Boley and V Gopalakrishnan (NIH, MD, USA) for the English revision.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.