Utility of apparent diffusion coefficient in characterization of different sinonasal pathologies

Area of Science:

• Radiology
• Oncology
• Otorhinolaryngology

Background:

• Sinonasal lesions present a diverse range, from benign to malignant tumors.
• Accurate preoperative characterization of these lesions is crucial for optimal surgical planning and patient outcomes.

Purpose of the Study:

• To evaluate the efficacy of apparent diffusion coefficient (ADC) values in distinguishing between benign and malignant sinonasal lesions.
• To compare the diagnostic performance of conventional MRI, diffusion-weighted MRI (DW-MRI), and ADC values.

Main Methods:

• Prospective study involving 59 patients undergoing sinonasal surgery.
• Diffusion-weighted magnetic resonance imaging (DW-MRI) with ADC calculation was performed for all cases.
• Radiological findings were correlated with histological diagnoses to determine diagnostic accuracy metrics.

Main Results:

• Median ADC values significantly differed between malignant (0.6 × 10⁻³), inflammatory (1.6 × 10⁻³), and benign (1.5 × 10⁻³) lesions (p < .001).
• Conventional MRI demonstrated high sensitivity (100%) and specificity (97%) for differentiating malignant from benign lesions.
• DW-MRI and ADC values showed high positive (96%) and negative (100%) predictive values for malignancy.

Conclusions:

• Conventional MRI and ADC values are highly effective in differentiating benign from malignant sinonasal lesions.
• DW-MRI does not significantly enhance diagnostic information beyond conventional MRI.
• DW-MRI can serve as a valuable adjunct to standard MRI in equivocal cases where malignancy is suspected.