Intravoxel Incoherent Motion Magnetic Resonance Imaging for Assessing Parotid Gland Tumors: Correlation and Comparison with Arterial Spin Labeling Imaging

Korean J Radiol. 2021 Feb;22(2):243-252. doi: 10.3348/kjr.2020.0290. Epub 2020 Sep 10.

Abstract

Objective: To compare and correlate the findings of intravoxel incoherent motion (IVIM) magnetic resonance (MR) imaging and arterial spin labeling (ASL) imaging in characterizing parotid gland tumors.

Materials and methods: We retrospectively reviewed 56 patients with parotid gland tumors evaluated by MR imaging. The true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and fraction of perfusion (f) values of IVIM imaging and tumor-to-parotid gland signal intensity ratio (SIR) on ASL imaging were calculated. Spearman rank correlation coefficient, chi-squared, Mann-Whitney U, and Kruskal-Wallis tests with the post-hoc Dunn-Bonferroni method and receiver operating characteristic curve assessments were used for statistical analysis.

Results: Malignant parotid gland tumors showed significantly lower D than benign tumors (p = 0.019). Within subgroup analyses, pleomorphic adenomas (PAs) showed significantly higher D than malignant tumors (MTs) and Warthin's tumors (WTs) (p < 0.001). The D* of WTs was significantly higher than that of PAs (p = 0.031). The f and SIR on ASL imaging of WTs were significantly higher than those of MTs and PAs (p < 0.05). Significantly positive correlation was found between SIR on ASL imaging and f (r = 0.446, p = 0.001). In comparison with f, SIR on ASL imaging showed a higher area under curve (0.853 vs. 0.891) in discriminating MTs from WTs, although the difference was not significant (p = 0.720).

Conclusion: IVIM and ASL imaging could help differentiate parotid gland tumors. SIR on ASL imaging showed a significantly positive correlation with f. ASL imaging might hold potential to improve the ability to discriminate MTs from WTs.

Keywords: Diffusion magnetic resonance imaging; Magnetic resonance imaging; Parotid neoplasms; Perfusion imaging.

MeSH terms

  • Adenolymphoma / diagnosis
  • Adenolymphoma / diagnostic imaging
  • Adult
  • Aged
  • Area Under Curve
  • Carcinoma, Acinar Cell / diagnosis
  • Carcinoma, Acinar Cell / diagnostic imaging
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Parotid Gland / diagnostic imaging*
  • Parotid Neoplasms / diagnosis*
  • Parotid Neoplasms / diagnostic imaging
  • ROC Curve
  • Retrospective Studies
  • Signal-To-Noise Ratio
  • Spin Labels

Substances

  • Spin Labels