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RT Journal Article
SR Electronic
T1 Apparent Diffusion Coefficient Mapping for Sinonasal Diseases: Differentiation of Benign and Malignant Lesions
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1100
OP 1106
DO 10.3174/ajnr.A2434
VO 32
IS 6
A1 Sasaki, M.
A1 Eida, S.
A1 Sumi, M.
A1 Nakamura, T.
YR 2011
UL http://www.ajnr.org/content/32/6/1100.abstract
AB BACKGROUND AND PURPOSE: CT and MR imaging features of benign and malignant sinonasal lesions are often nonspecific. Therefore, we evaluated the ADC-based differentiation of these lesions. MATERIALS AND METHODS: We retrospectively assessed ADCs of 61 patients with histologically proved sinonasal tumors and tumorlike lesions: 19 benign lesions, 28 malignant tumors, and 14 inflammatory lesions. Overall ADCs and percentages of total tumor area with extremely low, low, intermediate, or high ADCs (ADC mapping) were determined by using 2 b-values (500 and 1000 s/mm2). RESULTS: ADCs of malignant tumors (0.87 ± 0.32 × 10−3 mm2/s) were significantly lower than those of benign (1.35 ± 0.29 × 10−3 mm2/s, P &lt; .0001) and inflammatory (1.50 ± 0.50 × 10−3 mm2/s, P = .0002) lesions. On ADC mapping, percentages of total tumor area within malignant tumors having extremely low or low ADCs were significantly (P &lt; .0001) greater than those within benign and inflammatory lesions. Cutoff points for ADC mapping (≥78% of tumor areas having extremely low or low ADCs) effectively differentiated benign or inflammatory lesions and malignant tumors with 75% sensitivity, 94% specificity, 85% accuracy, and 91% positive and 82% negative predictive values, respectively. ADCs also effectively discriminated lymphomas and SCCs from other malignant tumors. CONCLUSIONS: ADC mapping may be an effective MR imaging tool for the differentiation of benign/inflammatory lesions from malignant tumors in the sinonasal area. ADCapparent diffusion coefficientCEcontrast-enhancedFSfat-suppressedHeteroheterogeneously enhancingHomohomogeneously enhancingInterintermediateMixedhyper-/iso-/hypointense signalsSCCsquamous cell carcinomaSENSEsensitivity encodingSPAIRspectral-attenuated inversion recoverySPIRspectral presaturation with inversion recoverySRBCTsmall round blue cell tumorsT1WIT1-weighted imagingT2WIT2-weighted imagingTICtime-intensity curveTSEturbo spin-echoUDCsundifferentiated carcinomas