Skip to main content
SpringerLink
Log in

Usefulness of diffusion-weighted MR imaging for differentiating between Warthin’s tumor and oncocytoma of the parotid gland

  • Original Article
  • Published:
Japanese Journal of Radiology Aims and scope Submit manuscript

Abstract

Purpose

To assess the efficacy of diffusion-weighted (DW) MR imaging for differentiating between Warthin’s tumor and oncocytoma of the parotid gland.

Methods

Forty-five histopathologically confirmed parotid gland tumors (41 Warthin’s tumors and 4 oncocytomas) were examined by MR imaging including DW imaging. 18F-fluorodeoxyglucose PET/CT was also performed in 9 Warthin’s tumors and 3 oncocytomas. We retrospectively reviewed the images and compared the MR signal intensities, apparent diffusion coefficients (ADCs), and maximum standardized uptake values (SUVmax) of the solid components between the two pathologies.

Results

The signal intensity ratios (SIRs) on both T2-weighted images (0.92 ± 0.18 vs 0.65 ± 0.13, p < 0.01) and DW images (1.24 ± 0.42 vs 0.43 ± 0.16, p < 0.001) were higher in Warthin’s tumors than in oncocytomas. ADCs (0.79 ± 0.11 vs 1.06 ± 0.06 × 10−3 mm2/s, p < 0.001) were lower in Warthin’s tumors than in oncocytomas. No significant differences in the SIRs on T1-weighted images (1.09 ± 0.12 vs. 0.99 ± 0.07, p = 0.051) and SUVmax (8.22 ± 3.86 vs. 8.11 ± 1.33, p = 0.864) were found between Warthin’s tumor and oncocytoma.

Conclusion

DW imaging with ADC measurements is useful for the differentiation of Warthin’s tumor from oncocytoma of the parotid gland.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Maiorano E, Lo Muzio L, Favia G, Piattelli A. Warthin’s tumour: a study of 78 cases with emphasis on bilaterality, multifocality and association with other malignancies. Oral Oncol. 2002;38:35–40.

    Article  CAS  PubMed  Google Scholar 

  2. Miyake H, Matsumoto A, Hori Y, Takeoka H, Kiyosue H, Hori Y, et al. Warthin’s tumor of parotid gland on Tc-99m pertechnetate scintigraphy with lemon juice stimulation: Tc-99m uptake, size, and pathologic correlation. Eur Radiol. 2001;11:2472–8.

    Article  CAS  PubMed  Google Scholar 

  3. Brandwein MS, Huvos AG. Oncocytic tumors of major salivary glands. A study of 68 cases with follow-up of 44 patients. Am J Surg Pathol. 1991;15:514–28.

    Article  CAS  PubMed  Google Scholar 

  4. Minami M, Tanioka H, Oyama K, Itai Y, Eguchi M, Yoshikawa K, et al. Warthin tumor of the parotid gland: MR-pathologic correlation. Am J Neuroradiol. 1993;14:209–14.

    CAS  PubMed  Google Scholar 

  5. Ikeda M, Motoori K, Hanazawa T, Nagai Y, Yamamoto S, Ueda T, et al. Warthin tumor of the parotid gland: diagnostic value of MR imaging with histopathologic correlation. Am J Neuroradiol. 2004;25:1256–62.

    PubMed  Google Scholar 

  6. Habermann CR, Arndt C, Graessner J, Diestel L, Petersen KU, Reitmeier F, et al. Diffusion-weighted echo-planar MR imaging of primary parotid gland tumors: is a prediction of different histologic subtypes possible? Am J Neuroradiol. 2009;30:591–6.

    Article  CAS  PubMed  Google Scholar 

  7. Patel ND, van Zante A, Eisele DW, Harnsberger HR, Glastonbury CM. Oncocytoma: the vanishing parotid mass. Am J Neuroradiol. 2011;32:1703–6.

    Article  CAS  PubMed  Google Scholar 

  8. Kasai T, Motoori K, Hanazawa T, Nagai Y, Ito H. MR imaging of multinodular bilateral oncocytoma of the parotid gland. Eur J Radiol Extra. 2007;63:97–100.

    Article  Google Scholar 

  9. Iida E, Wiggins RH 3rd, Anzai Y. Bilateral parotid oncocytoma with spontaneous intratumoral hemorrhage: a rare hypervascular parotid tumor with ASL perfusion. Clin Imaging. 2016;40:357–60.

    Article  PubMed  Google Scholar 

  10. Liu RS, Yeh SH, Yen TC, Hsu DF. Salivary scintigraphy with vitamin C stimulation: an aid in differentiating unilateral parotitis from Warthin’s tumor. Eur J Nucl Med. 1990;16:689–91.

    Article  CAS  PubMed  Google Scholar 

  11. Murata Y, Yamada I, Umehara I, Okada N, Shibuya H. Diagnostic accuracy of technetium-99m-pertechnetate scintigraphy with lemon juice stimulation to evaluate Warthin’s tumor. J Nucl Med. 1998;39:43–6.

    CAS  PubMed  Google Scholar 

  12. Sato T, Morita Y, Hamamoto S, Noikura T, Kawashima K, Matsune S, et al. Interpretation of scintigraphy of papillary cystadenoma lymphomatosum (Warthin’s tumor) on the basis of histopathologic findings. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;82:101–7.

    Article  CAS  PubMed  Google Scholar 

  13. Lunia S, Chodos RB, Lunia C, Chandramouly BS. Oxyphilic adenoma of the parotid gland. Identification with 99mTc-pertechnetate. Radiology. 1978;128:690.

    Article  CAS  PubMed  Google Scholar 

  14. Gates GA, Work WP. Radioisotope scanning of the salivary glands. A preliminary report. Laryngoscope. 1967;77:861–75.

    Article  CAS  PubMed  Google Scholar 

  15. Batsakis JG. Carcinoma ex papillary cystadenoma lymphomatosum. Malignant Warthin’s tumor. Ann Otol Rhinol Laryngol. 1987;96:234–5.

    Article  CAS  PubMed  Google Scholar 

  16. Reddy VM, Thangarajah T, Castellanos-Arango F, Panarese A. Conservative management of Warthin tumour. J Otolaryngol Head Neck Surg. 2008;37:744–9.

    PubMed  Google Scholar 

  17. Nakada M, Nishizaki K, Akagi H, Masuda Y, Yoshino T. Oncocytic carcinoma of the submandibular gland: a case report and literature review. J Oral Pathol Med. 1998;27:225–8.

    Article  CAS  PubMed  Google Scholar 

  18. Pinkston JA, Cole P. Cigarette smoking and Warthin’s tumor. Am J Epidemiol. 1996;144:183–7.

    Article  CAS  PubMed  Google Scholar 

  19. Freedman LS, Oberman B, Sadetzki S. Using time-dependent covariate analysis to elucidate the relation of smoking history to Warthin’s tumor risk. Am J Epidemiol. 2009;170:1178–85.

    Article  PubMed  Google Scholar 

  20. Kato H, Kanematsu M, Watanabe H, Mizuta K, Aoki M. Salivary gland tumors of the parotid gland: CT and MR imaging findings with emphasis on intratumoral cystic components. Neuroradiology. 2014;56:789–95.

    Article  PubMed  Google Scholar 

  21. Seifert G, Donath K. Multiple tumours of the salivary glands—terminology and nomenclature. Eur J Cancer B Oral Oncol. 1996;32B:3–7.

    Article  CAS  PubMed  Google Scholar 

  22. Tan TJ, Tan TY. CT features of parotid gland oncocytomas: a study of 10 cases and literature review. Am J Neuroradiol. 2010;31:1413–7.

    Article  CAS  PubMed  Google Scholar 

  23. Hisatomi M, Asaumi J, Konouchi H, Yanagi Y, Matsuzaki H, Kishi K. Assessment of dynamic MRI of Warthin’s tumors arising as multiple lesions in the parotid glands. Oral Oncol. 2002;38:369–72.

    Article  PubMed  Google Scholar 

  24. Kato H, Kanematsu M, Watanabe H, Kajita K, Mizuta K, Aoki M, et al. Perfusion imaging of parotid gland tumours: usefulness of arterial spin labeling for differentiating Warthin’s tumours. Eur Radiol. 2015;25:3247–54.

    Article  PubMed  Google Scholar 

  25. Shah VN, Branstetter BFt. Oncocytoma of the parotid gland: a potential false-positive finding on 18F-FDG PET. Am J Roentgenol. 2007;189:W212–4.

    Article  Google Scholar 

  26. Seo YL, Yoon DY, Baek S, Lim KJ, Yun EJ, Cho YK, et al. Incidental focal FDG uptake in the parotid glands on PET/CT in patients with head and neck malignancy. Eur Radiol. 2015;25:171–7.

    Article  PubMed  Google Scholar 

  27. Kitajima K, Suenaga Y, Sugimura K. Present and future role of FDG-PET/CT imaging in the management of head and neck carcinoma. Jpn J Radiol. 2015;33:776–89.

    Article  PubMed  Google Scholar 

  28. Matsushima N, Maeda M, Takamura M, Takeda K. Apparent diffusion coefficients of benign and malignant salivary gland tumors. Comparison to histopathological findings. J Neuroradiol. 2007;34:183–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan

    Hiroki Kato, Keita Fujimoto & Masayuki Matsuo

  2. Department of Otolaryngology, Gifu University School of Medicine, Gifu, Japan

    Keisuke Mizuta & Mitsuhiro Aoki

Authors
  1. Hiroki Kato
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Keita Fujimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Masayuki Matsuo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Keisuke Mizuta
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mitsuhiro Aoki
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hiroki Kato.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kato, H., Fujimoto, K., Matsuo, M. et al. Usefulness of diffusion-weighted MR imaging for differentiating between Warthin’s tumor and oncocytoma of the parotid gland. Jpn J Radiol 35, 78–85 (2017). https://doi.org/10.1007/s11604-016-0608-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11604-016-0608-5

Keywords

Search

Navigation