Related Experiment Video
Updated: Oct 29, 2025
Tracking the Mammary Architectural Features and Detecting Breast Cancer with Magnetic Resonance Diffusion Tensor Imaging
Published on: December 15, 2014
Differentiation of Benign and Malignant Parotid Gland Tumors with MRI and Diffusion Weighted Imaging
Umut Percem Orhan Soylemez1, Basak Atalay2
1Istanbul Medeniyet University Faculty of Medicine Goztepe Training and Research Hospital, Department of Radiology, Istanbul, Turkey.
Objective:
This study investigated the effectivity of Magnetic Resonance Imaging (MRI) findings and Apparent Diffusion Coefficient (ADC) value in evaluating parotid gland tumors (PGTs), and aimed to reduce the biopsy procedure before surgery.
Methods:
This retrospective study included 54 PGTs of 42 patients' (24 female, 18 male, mean age; 51.4±15.9). All of the patients had an MRI, and histopathologic diagnosis. The signal intensity [T1 and T2 Weighted (W), T1W after intravenous contrast agent injection] and mean ADC values of the PGTs were measured. Also contrast enhancement pattern (homogenous, heterogeneous, peripheral or none), margin features (well or ill-defined), sizes, location (superficial lobe/deeplobe/both), perineural spread, presence of lymphadenopathy, and extension to adjacent structures were noted.
Results:
The distribution of PGTs was; 21 pleomorphic adenomas, 18 Warthin tumors, 2 lymph nodes, 2 mucoepidermoid carcinomas, 5 adenoid cystic carcinoma, 1 basal cell carcinoma,2 metastases and 2 lymphomas; (13 malignant and 41 benign lesions). Morphologic parameters; ill-defined margin, perineural spread, lymphadenopathy, and extension to adjacent structures were found to be significantly associated with malign lesions (p<0.01). There was a significant difference between ADC values of malignant and benign PGTs (p<0.05). Also ADC values and T2 signal intensity was significantly lower in Warthin tumors rather than pleomorphic adenomas (p<0.05).
Conclusions:
Mean ADC values when considered with morphological features may be accessible methods to distinguish benign and malignant PGTs, also ADC values and T2 signal intensity may be useful for differentiating pleomorphic adenomas from Warthin tumors, thereby reducing the number of biopsies and thus complications.
Insights
Magnetic Resonance Imaging (MRI) and Apparent Diffusion Coefficient (ADC) values can help differentiate parotid gland tumors. These imaging techniques may reduce the need for biopsies, distinguishing benign from malignant lesions and specific tumor types.
Area of Science:
- Radiology and Imaging
- Oncology
- Otolaryngology
Background:
- Parotid gland tumors (PGTs) require accurate preoperative evaluation.
- Distinguishing benign from malignant PGTs and specific tumor subtypes is crucial for treatment planning.
- Minimizing invasive procedures like biopsies is desirable.
Purpose of the Study:
- To evaluate the effectiveness of Magnetic Resonance Imaging (MRI) findings and Apparent Diffusion Coefficient (ADC) values in assessing parotid gland tumors (PGTs).
- To explore the potential of MRI and ADC values to reduce the necessity of preoperative biopsy for PGTs.
- To differentiate between benign and malignant PGTs, and between common benign tumors like pleomorphic adenomas and Warthin tumors.
Main Methods:
- Retrospective analysis of 54 PGTs from 42 patients.
- All patients underwent MRI with histopathologic diagnosis.
- Assessed signal intensities (T1W, T2W, post-contrast T1W), mean ADC values, enhancement patterns, margins, size, location, perineural spread, lymphadenopathy, and adjacent structure extension.
Main Results:
- Morphological features (ill-defined margin, perineural spread, lymphadenopathy, adjacent extension) were significantly associated with malignant PGTs (p<0.01).
- Mean ADC values significantly differed between malignant and benign PGTs (p<0.05).
- ADC values and T2 signal intensity were significantly lower in Warthin tumors compared to pleomorphic adenomas (p<0.05).
Conclusions:
- Mean ADC values combined with morphological features offer a viable method for distinguishing benign from malignant PGTs.
- ADC values and T2 signal intensity can aid in differentiating pleomorphic adenomas from Warthin tumors.
- These imaging parameters may reduce the number of biopsies required, thereby minimizing potential complications.
