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Added value of susceptibility-weighted imaging to diffusion-weighted imaging in the characterization of parotid gland tumors

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Abstract

Purpose

To assess the added value of susceptibility-weighted imaging (SWI) to diffusion-weighted imaging (DWI) in the characterization of parotid gland tumors.

Methods

Seventy-eight patients with pathologically confirmed parotid gland tumors, who underwent DWI and SWI for pre-surgery evaluation, were enrolled. Apparent diffusion coefficient (ADC) and degree of intratumoral susceptibility signal intensity (ITSS) were measured and compared between benign and malignant groups, and among pleomorphic adenoma (PA), Warthin tumor (WT) and malignant tumor (MT). Independent sample t test, one-way analysis of variance and receiver operating characteristic curve analysis were used for statistical analyses.

Results

Benign parotid gland tumor showed a significantly higher mean ADC value than malignant tumors (0.836 ± 0.350 vs 0.592 ± 0.163, p = 0.001). Setting an average ADC value of 0.679 as the cut-off value, optimal differentiating performance could be obtained (AUC, 0.700; sensitivity, 62.69%; specificity, 81.82%) for differentiating malignant from benign tumors. PA showed significantly higher mean ADC and less ITSS than WT (ADC, p < 0.001; ITSS, p = 0.033) and MT (ADC, p < 0.001; ITSS, p = 0.024), while the difference between WT and MT was not significant (ADC, p = 0.826; ITSS, p = 0.539). After integration with ITSS, the diagnostic performance of ADC was improved for differentiating PA from WT (AUC 0.921 vs 0.873) and from MT (AUC 0.906 vs 0.882).

Conclusion

SWI could provide added information to DWI and serve as a supplementary imaging marker for the characterization of parotid gland tumors.

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Acknowledgements

We want to express our thanks to Yong-Ming Dai from United Imaging Healthcare for his help in MRI protocol setting and manuscript correction.

Funding

This work was supported by National Natural Science Foundation of China (81771796 to FY Wu), and Jiangsu Province’s Young Medical Talents Program (QNRC2016560 to Xu XQ).

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Author notes

  1. Jia-Suo Jiang and Liu-Ning Zhu contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Rd., Nanjing, People’s Republic of China

    Jia-Suo Jiang, Wei Chen, Lu Chen, Guo-Yi Su, Xiao-Quan Xu & Fei-Yun Wu

  2. Department of Stomatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China

    Liu-Ning Zhu

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  1. Jia-Suo Jiang
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  2. Liu-Ning Zhu
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  4. Lu Chen
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  5. Guo-Yi Su
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Corresponding authors

Correspondence to Xiao-Quan Xu or Fei-Yun Wu.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the institutional review board of our hospital and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Written informed consent was waived due to the nature of retrospective study.

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Jiang, JS., Zhu, LN., Chen, W. et al. Added value of susceptibility-weighted imaging to diffusion-weighted imaging in the characterization of parotid gland tumors. Eur Arch Otorhinolaryngol 277, 2839–2846 (2020). https://doi.org/10.1007/s00405-020-05985-x

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  • DOI: https://doi.org/10.1007/s00405-020-05985-x

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