Role of resolve DWI and DCE MRI in differentiating benign and malignant skull base lesions
Pradeep Mohanasundaram1, Jyoti Kumar2, Gaurav Shanker Pradhan1
1Department of Radiodiagnosis, Maulana Azad Medical College, New Delhi, India.
Purpose:
To assess the utility of RESOLVE Diffusion-Weighted Imaging (DWI) and Dynamic Contrast-Enhanced (DCE) MRI in differentiating benign and malignant skull base lesions using qualitative and quantitative imaging parameters.
Methods:
This prospective study included 44 patients with 45 skull base lesions who underwent MRI with RESOLVE DWI and DCE-MRI. Apparent diffusion coefficient (ADC) values and lesion-to-medulla ADC ratios were calculated from DWI. Perfusion parameters (Ktrans, Kep, Ve) and time-intensity curve (TIC) were derived from DCE-MRI. Benign and malignant lesions were statistically compared, and receiver operating characteristic analysis was performed to evaluate diagnostic capability.
Results:
Malignant lesions had significantly lower mean ADC values (0.88 × 10⁻³ mm²/s) than benign lesions (1.05 × 10⁻³ mm²/s, p = 0.033). The lesion-to-medulla ADC ratio was also significantly lower in malignant lesions (1.03 vs. 1.25, p = 0.029), yielding 89% sensitivity and 44% specificity at a cutoff ≤ 1.167 (AUC = 0.695). Among DCE-MRI parameters, both Kep and the distribution of time-intensity curve (TIC) showed significant differences between benign and malignant lesions (p = 0.037 and p < 0.001, respectively). Kep was higher in malignant lesions (0.98 vs. 0.78), with an AUC of 0.689, 94% sensitivity, and 52% specificity at a cutoff of ≥ 0.581. Ktrans and Ve did not show significant statistical difference.
Conclusion:
RESOLVE DWI and DCE-MRI are effective non-invasive tools for differentiating benign and malignant skull base lesions. The ADC ratio and Kep are valuable quantitative markers, while TIC pattern analysis offers complementary qualitative insights, enhancing diagnostic confidence.
