Diffusion kurtosis imaging for differentiating between the benign and malignant sinonasal lesions

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Sinonasal lesions present a diagnostic challenge, requiring accurate differentiation between benign and malignant types.
• Conventional MRI and diffusion-weighted imaging (DWI) have limitations in fully characterizing these lesions.

Purpose of the Study:

• To evaluate the efficacy of diffusion kurtosis imaging (DKI) in differentiating benign from malignant sinonasal lesions.
• To compare the diagnostic performance of DKI against DWI for sinonasal lesion characterization.

Main Methods:

• Eighty-one patients with pathologically confirmed sinonasal lesions underwent conventional MRI, DWI, and DKI.
• DKI utilized an extended b-value range (0-2500 s/mm²).
• Apparent diffusion coefficient (ADC) from DWI, and kurtosis (K) and diffusion coefficient (D) from DKI were measured and compared.

Main Results:

• Malignant lesions showed significantly lower ADC and D values compared to benign lesions (P<0.0001).
• Malignant lesions exhibited significantly higher K values than benign lesions (P<0.0001).
• DKI's K value achieved higher accuracy (87.7%) in differentiation than ADC (74.0%), with a larger area under the curve (0.875 vs. 0.762, P<0.05).

Conclusions:

• The kurtosis (K) value derived from DKI demonstrates superior accuracy in differentiating benign and malignant sinonasal lesions compared to the apparent diffusion coefficient (ADC) from DWI.
• DKI represents a potentially valuable noninvasive imaging technique for the evaluation of sinonasal lesions.