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Correlation between MRI (DWI and DCE) and cellularity of parotid gland pleomorphic adenomas
Laura Monestier1, Jean Del Grande2, Ralph Haddad1
1Department of Oto-Rhino-Laryngology-Head and Neck Surgery, La Conception University Hospital, AP-HM, Aix-Marseille University, Marseille, France.
Purpose:
Parotid pleomorphic adenomas present a risk of recurrence, higher when the tumour is a hypocellular subtype. The aim of the study was to determine whether it is possible to characterize this histological subtype with diffusion and perfusion sequences of the preoperative MRI.
Methods:
This retrospective study included 97 patients operated between 2010 and 2020. Histologic slides review was performed to classify tumours into three histologic subtypes: hypocellular, classical and hypercellular. Univariate and multivariate analyses studied the correlation between histology and diffusion and perfusion MRI parameters obtained with OleaSphere® software.
Results:
The hypocellular subtype had higher apparent diffusion coefficient values than the other two subtypes: 2.13 ± 0.23, 1.83 ± 0.42, and 1.61 ± 0.4 × 10-3 mm2/s for hypocellular, classical and hypercellular subtype respectively (p < 0.0001). Multivariate analysis showed that an ADCmean > 1.88 × 10-3 mm2/s was suggestive of a hypocellular pleomorphic adenoma in 79% of the cases, with a specificity and PPV of 94 and 96% (p < 0.001), respectively.
Conclusion:
The histological subtype of a pleomorphic adenoma can be predicted preoperatively with ADC values. A prospective and multicentric study on a larger cohort is needed to confirm our results.
Insights
Preoperative MRI using apparent diffusion coefficient (ADC) values can predict hypocellular parotid pleomorphic adenomas. This aids in identifying tumors with a higher recurrence risk before surgery.
Area of Science:
- Radiology
- Oncology
- Pathology
Background:
- Parotid pleomorphic adenomas pose a recurrence risk, particularly the hypocellular subtype.
- Accurate preoperative characterization of tumor histology is crucial for treatment planning.
Purpose of the Study:
- To investigate if diffusion and perfusion MRI sequences can characterize hypocellular parotid pleomorphic adenomas preoperatively.
- To correlate MRI findings with histological subtypes.
Main Methods:
- Retrospective analysis of 97 patients operated between 2010-2020.
- Histological classification into hypocellular, classical, and hypercellular subtypes.
- Correlation of MRI parameters (diffusion, perfusion) with histology using univariate and multivariate analyses.
Main Results:
- Hypocellular subtype showed significantly higher apparent diffusion coefficient (ADC) values compared to classical and hypercellular subtypes (p < 0.0001).
- Multivariate analysis indicated ADCmean > 1.88 × 10⁻³ mm²/s predicted hypocellular subtype with 79% accuracy, 94% specificity, and 96% positive predictive value (p < 0.001).
Conclusions:
- Preoperative MRI, specifically ADC values, can predict the histological subtype of parotid pleomorphic adenomas.
- Further prospective, multicentric studies are recommended to validate these findings in a larger cohort.
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