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Assessment of nasal and paranasal sinus masses by diffusion-weighted MR imaging
A A K A Razek1, S Sieza, B Maha
1Diagnostic radiology department, Mansoura faculty of medicine, 62, ElNokrasi street, Meet Hadr, 53312 Mansoura, Egypt. arazek@mans.eun.eg
Purpose:
To assess nasal and paranasal sinus masses by diffusion-weighted echoplanar magnetic resonance imaging (MRI).
Patients And Methods:
This prospective study included 55 consecutive patients (34 males, 21 females; aged 14-64 years, mean 39 years) with nasal and paranasal sinus masses. All underwent diffusion-weighted MRI using single-shot echoplanar imaging (EPI) with a b factor of 0.500 and 1000 s/mm2. Apparent diffusion coefficient (ADC) maps were constructed, allowing ADC values of the mass to be calculated and correlated with histopathological findings.
Results:
The mean ADC value of nasal and paranasal sinus malignant lesions (1.10+/-0.25x10(-3) mm2/s) was significantly different (P=0.001) from that of benign lesions (1.78+/-0.41x10(-3) mm2/s). Also, there was a significant ADC difference between carcinoma and sarcoma (P=0.01) as well as between well differentiated and poorly differentiated malignancies (P=0.005). Using an ADC value of 1.53x10(-3) mm2/s as the threshold value for differentiating malignant from benign lesions, the best result obtained had an accuracy of 93%, sensitivity of 94%, specificity of 92%, a positive predictive value of 92% and negative predictive value of 94%. However, the use of 0.97x10(-3) mm2/s and 1.16x10(-3) mm2/s as threshold values to differentiate carcinomas from sarcomas and poorly differentiated malignancy, respectively, gave the best results.
Conclusion:
The ADC value is a non-invasive imaging parameter that can be used to assess nasal and paranasal sinus masses, as it can help in the differentiation of malignant tumors from benign lesions, and in the characterization and grading of malignancies.
Insights
Diffusion-weighted MRI using apparent diffusion coefficient (ADC) values can effectively differentiate malignant from benign nasal and paranasal sinus masses. This non-invasive imaging technique aids in tumor characterization and grading.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Nasal and paranasal sinus masses require accurate assessment for diagnosis and treatment planning.
- Distinguishing between benign and malignant lesions is crucial for patient management.
- Non-invasive imaging techniques are sought to complement histopathological analysis.
Purpose of the Study:
- To evaluate the utility of diffusion-weighted echoplanar magnetic resonance imaging (MRI) in assessing nasal and paranasal sinus masses.
- To determine if apparent diffusion coefficient (ADC) values can differentiate between benign and malignant lesions.
- To explore the role of ADC values in characterizing and grading malignancies.
Main Methods:
- Prospective study involving 55 patients with nasal and paranasal sinus masses.
- Diffusion-weighted MRI using single-shot echoplanar imaging (EPI) with b-factors of 0.500 and 1000 s/mm².
- Calculation of apparent diffusion coefficient (ADC) values and correlation with histopathological findings.
Main Results:
- Significantly lower mean ADC values were observed in malignant lesions (1.10±0.25x10⁻³ mm²/s) compared to benign lesions (1.78±0.41x10⁻³ mm²/s) (P=0.001).
- Significant ADC differences were found between carcinoma and sarcoma (P=0.01) and between well-differentiated and poorly differentiated malignancies (P=0.005).
- A threshold ADC value of 1.53x10⁻³ mm²/s achieved 93% accuracy, 94% sensitivity, and 92% specificity in differentiating malignant from benign lesions.
Conclusions:
- Apparent diffusion coefficient (ADC) values derived from diffusion-weighted MRI serve as a valuable non-invasive parameter for assessing nasal and paranasal sinus masses.
- ADC values can effectively differentiate malignant tumors from benign lesions.
- This imaging parameter aids in the characterization and grading of malignancies within the nasal and paranasal sinuses.
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