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Correlation between MRI (DWI and DCE) and cellularity of parotid gland pleomorphic adenomas

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Abstract

Purpose

Parotid pleomorphic adenomas present a risk of recurrence, higher when the tumour is a hypocellular subtype. The aim of the study was to determine whether it is possible to characterize this histological subtype with diffusion and perfusion sequences of the preoperative MRI.

Methods

This retrospective study included 97 patients operated between 2010 and 2020. Histologic slides review was performed to classify tumours into three histologic subtypes: hypocellular, classical and hypercellular. Univariate and multivariate analyses studied the correlation between histology and diffusion and perfusion MRI parameters obtained with OleaSphere® software.

Results

The hypocellular subtype had higher apparent diffusion coefficient values than the other two subtypes: 2.13 ± 0.23, 1.83 ± 0.42, and 1.61 ± 0.4 × 10–3 mm2/s for hypocellular, classical and hypercellular subtype respectively (p < 0.0001). Multivariate analysis showed that an ADCmean > 1.88 × 10–3 mm2/s was suggestive of a hypocellular pleomorphic adenoma in 79% of the cases, with a specificity and PPV of 94 and 96% (p < 0.001), respectively.

Conclusion

The histological subtype of a pleomorphic adenoma can be predicted preoperatively with ADC values. A prospective and multicentric study on a larger cohort is needed to confirm our results.

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Abbreviations

PA:

Pleomorphic adenoma

DCE-wi:

Dynamic contrast enhanced weighted imaging

DWI:

Diffusion weighted imaging

ROI:

Region of interest

ADC:

Apparent diffusion coefficient

b0, b100, b500, b1000:

Diffusion weighting factor b, where b = 0, 100, 500 or 1000 s/mm2

Vp:

Plasma volume

Ve:

Extracellular space volume

k trans :

Transfer rate of contrast medium from plasma to extracellular extravascular space

k ep :

Return transfer rate of the contrast medium from the extracellular extravascular space to the plasma

Washin:

Slope of the rising part of the contrast uptake curve as a function of time

Washout:

Rate of decrease of the contrast curve after it has reached its maximum, corresponding to the washout of the tissue studied

Curve washout:

Percentage of the downward slope of the concentration curve as a function of time (washout of the contrast medium)

AUC:

Area under the curve, or area under the concentration curve. Amount of contrast medium over the entire acquisition time

Peak:

Maximum concentration of contrast medium reached during the acquisition

Peak enhancement:

Peak enhancement percentage, or percentage increase in the initial slope of the concentration curve as a function of time

TME:

Time to maximum enhancement. The time required to reach the maximum signal intensity, i.e. the maximum concentration of the contrast medium

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Author notes

  1. Nicolas Fakhry and Arthur Varoquaux have equally contributed to this work and should be regarded as joint senior authors.

Authors and Affiliations

  1. Department of Oto-Rhino-Laryngology-Head and Neck Surgery, La Conception University Hospital, AP-HM, Aix-Marseille University, Marseille, France

    Laura Monestier, Ralph Haddad, Laure Santini, Justin Michel & Nicolas Fakhry

  2. Department of Pathology, La Timone University Hospital, AP-HM, Aix-Marseille University, Marseille, France

    Jean Del Grande

  3. Department of Radiology, La Conception University Hospital, AP-HM, Aix-Marseille University, Marseille, France

    Arthur Varoquaux

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Monestier, L., Del Grande, J., Haddad, R. et al. Correlation between MRI (DWI and DCE) and cellularity of parotid gland pleomorphic adenomas. Eur Arch Otorhinolaryngol 281, 2655–2665 (2024). https://doi.org/10.1007/s00405-024-08562-8

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