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Published on: January 17, 2018
Dynamic Contrast-Enhanced MRI Can Quantitatively Discriminate the Original Site From Peripheral Portion of Sinonasal
Zheng Li1, Mu Xian2, Jian Guo1
1Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Background:
Identification of the original site of sinonasal inverted papillomas (SIPs) is difficult but essential for reducing the recurrence rate. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) may provide information about tissue perfusion and permeability to solve this problem.
Purpose:
To investigate the accuracy of DCE-MRI parameters in discriminating between regions of interest (ROIs) in the original site and peripheral portion.
Study Type:
Retrospective.
Population:
Ninety consecutive patients with pathologically proven SIP.
Field Strength/Sequence:
3.0T/DCE-MRI using fast-spoiled gradient recalled (FSPGR) T1 -weighted images with fat saturation.
Assessment:
ROIs were placed in the original site and the peripheral portion of SIP by two radiologists according to surgical records. Maximum slope of increase (MaxSlope), contrast-enhancement ratio (CER), bolus arrival time (BAT), initial area under the signal intensity-time curve (IAUGC), volume transfer constant (Ktrans ), volume of the extravascular extracellular space (ve ), and rate constant (Kep ) were calculated and repeated again with a month interval by a radiologist.
Statistical Tests:
Univariate and multivariate analysis was used to determine the best diagnostic parameters, and their performances in discrimination were evaluated by receiver operating characteristic (ROC) curves. Reproducibility was estimated by the intraclass correlation coefficient (ICC).
Results:
MaxSlope, CER, IAUGC, Ktrans , and ve were significantly lower (P < 0.05) in the original site than the peripheral portion of SIPs. CER (odds ratio [OR] = 0.227, 95% confidence interval [95% CI] = 0.073-0.704) and ve (OR = 0.048, 95% CI = 0.004-0.527) were the best indicators for identifying the original ROIs. The combination of CER and ve had the best diagnostic performance in the discrimination between the ROIs (the area under the curve [AUC]: 0.937; 95% CI: 0.896-0.974).
Data Conclusion:
DCE-MRI derived parameter values differed between the original site and the peripheral portion of SIPs. The model combining CER and ve appears to be able to accurately distinguish the original from peripheral ROIs.
Level Of Evidence:
4 TECHNICAL EFFICACY STAGE: 2.
Insights
Dynamic contrast-enhanced MRI (DCE-MRI) can identify the original site of sinonasal inverted papillomas (SIPs). Parameters like contrast-enhancement ratio (CER) and the volume of the extravascular extracellular space (ve) accurately differentiate tumor origins, aiding in reducing recurrence.
Area of Science:
- Oncology
- Radiology
- Medical Imaging
Background:
- Identifying the original site of sinonasal inverted papillomas (SIPs) is crucial for minimizing recurrence rates.
- Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) shows potential in assessing tissue perfusion and permeability for SIP localization.
Purpose of the Study:
- To evaluate the accuracy of DCE-MRI parameters in distinguishing between the original tumor site and peripheral regions of SIPs.
Main Methods:
- A retrospective study analyzed 90 patients with pathologically confirmed SIPs using 3.0T DCE-MRI.
- Regions of interest (ROIs) were defined in the original and peripheral sites. Parameters calculated included MaxSlope, CER, BAT, IAUGC, Ktrans, ve, and Kep.
- Statistical analysis involved univariate and multivariate analyses, ROC curves for discrimination, and ICC for reproducibility.
Main Results:
- Several DCE-MRI parameters (MaxSlope, CER, IAUGC, Ktrans, ve) were significantly lower in the original SIP site compared to the peripheral portion (P < 0.05).
- Contrast-enhancement ratio (CER) and volume of the extravascular extracellular space (ve) emerged as the strongest indicators for identifying original ROIs.
- A combined model of CER and ve demonstrated high diagnostic performance (AUC: 0.937) in discriminating between original and peripheral ROIs.
Conclusions:
- DCE-MRI derived parameters exhibit significant differences between the original and peripheral sites of SIPs.
- The combination of CER and ve provides an accurate method for distinguishing the original tumor site from peripheral regions, aiding surgical planning and potentially reducing recurrence.
