Highlights
- •Differentiation between WTs and other parotid tumors remains challenging.
- •The best MR features of WT included bilaterality, ADC < 905.1, and T1 hyperintensity.
- •MRI score cut-off value of 7 indicated 100% specificity and 100% PPV for WTs.
Abstract
Objectives
Despite known characteristic radiologic and clinical features, differentiation between
Warthin's tumor (WT) and other parotid tumors remains challenging. The purpose of
this study was to more precisely assess the MR imaging features of WT and to develop
a scoring system combining the most specific characteristics.
Methods
A total of 208 patients with parotid gland tumors and presurgical MRI were included.
Tumors were divided into 5 histological subtypes, and different MRI features were
compared between groups. An MRI scoring test was developed including MR parameters
that contributed significantly in distinguishing WT from other tumors.
Results
The best MRI features for differentiating between WTs from other tumors included bilaterality
(P = 0.002), multifocality (P < 0.001), ADC values <905.1 (P < 0.001), and high signal intensity on T1-W images (P < 0.001). Six or more points on the 14-point scoring MRI scale was associated with
an area under the curve of 0.99 (Accuracy of 98%), while a cut-off value of 7 indicated
100% specificity and 100% positive predictive value.
Conclusions
Ill-defined margins, low T1-W signal, and location in the upper 2/3 of the parotid
gland excluded WTs in 100% of cases. The proposed scoring method allows WTs to be
distinguished from other tumors with high accuracy.
Key points
- •Despite known characteristic radiologic and clinical features, differentiation between Warthin's tumor (WT) and other parotid tumors remains challenging.
- •The best MRI features for differentiating between WTs from other tumors included bilaterality, multifocality, ADC values <905.1, and high signal intensity on T1-W images.
- •Six or more points on the 14-point scoring MRI scale was associated with an area under the curve of 0.99, while a cut-off value of 7 indicated 100% specificity and 100% positive predictive value.
Abbreviations:
WT (Warthin's tumor), ACC (acinic cell carcinoma), MEC (mucoepidermoid carcinoma), ROC (receiving operating characteristics), AUC (area under the curve), MRI (magnetic resonance imaging), DWI (diffusion-weighted imaging), ADC (apparent diffusion coefficient)Keywords
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Article info
Publication history
Published online: September 21, 2021
Accepted:
September 13,
2021
Received in revised form:
September 6,
2021
Received:
July 5,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
