Highlights
- •Mean ADCmean and ADCratio were significantly higher in ACC than in SCC, lymphoma, SNUC, and neuroendocrine carcinoma.
- •The ADCmean threshold of 0.80 (10−3 mm2/s) could be used to differentiate ACC from non-ACC sinonasal neoplasms.
- •ADC values were not different between MM, poorly differentiated carcinoma, metastasis, sarcoma, ONB, and adenocarcinoma.
Abstract
Purpose
To evaluate the potential contribution of quantitative DWI parameters including ADCmean and ADCratio values to help in distinguishing the histopathological types of sinonasal neoplasms.
Methods
This retrospective study included 83 patients (50 males, 33 females; mean age 61 years)
with pathologically proven untreated sinonasal neoplasms who have undergone diffusion-weighted
MRI imaging from February 2010 to August 2017. Diffusion-weighted MRI was performed
on a 3 T unit with b factors of 0 and 1000 s/mm2, and ADC maps were generated. Mean ADC values of sinonasal tumors and ADC ratios
(ADCmean of the tumor to ADCmean of pterygoid muscles) were compared with the histopathological diagnosis by utilizing
the Kruskal-Wallis non-parametric test.
Results
Mean ADCmean and ADCratio were 0.8 (SD, ±0.4) × (10−3 mm2/s) and 1.2 (SD, ±0.5), respectively, and each parameter was significantly different
between histopathological types (p < 0.05). Mean ADCmean and ADCratio were higher in adenoid cystic carcinoma (ACC) than in SCC, lymphoma, neuroendocrine
carcinoma and sinonasal undifferentiated carcinoma (SNUC) (p < 0.05). Optimized ADCmean thresholds of 0.79, 0.81, 0.74 and 0.78 (10−3 mm2/s) achieved maximal discriminatory accuracies of 100%, 79%, 100% and 89% for ACC/SNUC,
ACC/SCC, ACC/neuroendocrine carcinoma, and ACC/lymphoma, respectively.
Conclusions
The optimized ADCmean threshold of 0.80 (10−3 mm2/s) could be used to differentiate ACC from non-ACC sinonasal neoplasms with maximal
discriminatory accuracy (82%) and sensitivity of 100%. However, there is considerable
overlapping of the ADCmean and ADCratio values among non-ACC sinonasal neoplasms hence surgical biopsy is still needed.
Keywords
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Article info
Publication history
Published online: February 07, 2019
Accepted:
February 6,
2019
Received in revised form:
January 20,
2019
Received:
September 4,
2018
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
