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Differentiating sinonasal malignant melanoma from squamous cell carcinoma using DWI combined with conventional MRI

  • Head-Neck-ENT Radiology
  • Published:
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Abstract

Purpose

This study aimed to investigate the feasibility of diffusion-weighted imaging (DWI) in combination with conventional MRI features to differentiate sinonasal malignant melanoma (SNMM) from sinonasal squamous cell carcinoma (SNSCC).

Methods

A total of 37 patients with SNMM and 44 patients with SNSCC were retrospectively reviewed. Conventional MRI features and apparent diffusion coefficients (ADCs) were evaluated independently by two experienced head and neck radiologists. ADCs were obtained from two different regions of interest (ROIs) including maximum slice (MS) and small solid sample (SSS). Multivariate logistic regression analysis was performed to identify significant MR imaging features in discriminating between SNMM and SNSCC. Receiver operating characteristic (ROC) curves were used to assess the diagnostic performance.

Results

SNMMs were more frequently located in the nasal cavity, with well-defined border, T1 Septate Pattern (T1-SP) and heterogeneous T1 hyperintensity, whereas SNSCCs were more frequently located in the paranasal sinus, with homogenous T1 isointensity, ill-defined border, reticular or linear T2 hyperintensity, and pterygopalatine fossa or orbital involvement (all p < 0.05). The mean ADCs of SNMM (MS ADC, 0.85 × 10−3mm2/s; SSS ADC, 0.69 × 10−3mm2/s) were significantly lower than those of SNSCC (MS ADC, 1.05 × 10−3mm2/s; SSS ADC, 0.82 × 10−3mm2/s) (p < 0.05). With a combination of location, T1 signal intensity, reticular or linear T2 hyperintensity, and a cut-off MS ADC of 0.87 × 10−3mm2/s, the sensitivity, specificity, and AUC were 97.3%, 68.2%, and 0.89, respectively.

Conclusion

DWI combined with conventional MRI can effectively improve the diagnostic performance in differentiating SNMM from SNSCC.

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Data availability

The processed data required to reproduce these findings cannot be shared at this time as the data also forms part of an ongoing study.

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Acknowledgements

We kindly thank Dr. Zheng Li from Beijing Tongren Hospital, Capital Medical University, for the revision of this manuscript and language polishing.

Funding

Beijing Municipal Administration of Hospitals' Ascent Plan [Code: DFL20190203]. Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support [Code: ZYLX201704].

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Author notes

  1. HL and XW contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Beijing Tongren Hospital, Capital Medical University, No. 1, DongJiaoMinXiang Street, DongCheng District, Beijing, 100730, China

    Hangzhi Liu, Xinyan Wang, Mingyue Su, Ning Wang & Junfang Xian

Authors
  1. Hangzhi Liu
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  2. Xinyan Wang
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  3. Mingyue Su
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  4. Ning Wang
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Contributions

Hangzhi Liu, M.D., was responsible for measurements and statistical analyses of patient data and writing of original draft. Junfang Xian, Ph.D., was responsible for formulation of overarching research goals, acquisition of the financial support for the project leading to this publication, and leadership responsibility for the research. Xinyan Wang, M.D., and Mingyue Su, M.D., were responsible for collections of clinical and imaging data. Ning Wang, M.D., was responsible for collections of measurements of data.

Corresponding author

Correspondence to Junfang Xian.

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We declare that we have no conflict of interest.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Written informed consent was waived because of the retrospective nature of the study.

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Written informed consent for publication was obtained from all participants.

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Liu, H., Wang, X., Su, M. et al. Differentiating sinonasal malignant melanoma from squamous cell carcinoma using DWI combined with conventional MRI. Neuroradiology 65, 1263–1270 (2023). https://doi.org/10.1007/s00234-023-03164-3

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  • DOI: https://doi.org/10.1007/s00234-023-03164-3

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