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Histogram analysis of apparent diffusion coefficient maps for differentiating malignant from benign parotid gland tumors

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Abstract

Purpose

To evaluate the diagnostic performance of histogram parameters derived from diffusion-weighted imaging (DWI) for differentiating malignant from benign parotid gland tumors compared with that of hotspot region of interest (ROI)-based apparent diffusion coefficient (ADC) measurement.

Methods

Our study retrospectively enrolled 60 patients with parotid gland tumors who had undergone DWI scan for pre-treatment evaluation. ADC measurements were performed using hotspot ROI (ADCHS-ROI)-based and histogram-based approach. Histogram parameters included mean (ADCmean), median (ADCmedian), 10th (ADC10), 90th (ADC90) percentiles, skewness and kurtosis of ADC. Mann–Whitney U test, Kruskal–Wallis test with post hoc Dunn–Bonferroni method and receiver operating characteristic (ROC) curve analyses were used for statistical analyses.

Results

ADCHS-ROI and ADC histogram parameters showed no significant differences between malignant and benign parotid gland tumors (All Ps > 0.05). Within the sub-group analyses, Warthin’s tumors showed the lowest ADCHS-ROI, ADCmean, ADCmedian, ADC10 and ADC90 value, followed by malignant tumors and pleomorphic adenomas (All Ps < 0.05). ADC10 out-performed ADCHS-ROI in differentiating malignant tumors from pleomorphic adenomas (area under curve, 0.890 vs 0.821; sensitivity, 79.31 vs 82.76%; specificity, 90.91 vs 72.73%; P = 0.016), and improved the diagnostic performance in differentiating malignant tumors from Warthin’s tumors (area under curve, 1.000 vs 0.965; sensitivity, 100.00 vs 90.91%), although the difference was not significant (P = 0.348).

Conclusions

ADC histogram analysis, especially ADC10, might be a promising imaging biomarker for characterizing parotid gland tumors.

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Funding

This work was supported by National Natural Science Foundation of China (81771796 to FY Wu), and Jiangsu Province’s Young Medical Talents Program (QNRC2016560 to Xu XQ).

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Author notes

  1. Gao Ma and Liu-Ning Zhu contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital of Nan**g Medical University, No. 300, Guangzhou Rd., Gulou District, Nan**g, People’s Republic of China

    Gao Ma, Guo-Yi Su, Hao Hu, Wen Qian, **ao-Quan Xu & Fei-Yun Wu

  2. Department of Stomatology, The First Affiliated Hospital of Nan**g Medical University, Nan**g, People’s Republic of China

    Liu-Ning Zhu & Shou-Shan Bu

Authors
  1. Gao Ma
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  2. Liu-Ning Zhu
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  4. Hao Hu
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  5. Wen Qian
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Correspondence to **ao-Quan Xu or Fei-Yun Wu.

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Ma, G., Zhu, LN., Su, GY. et al. Histogram analysis of apparent diffusion coefficient maps for differentiating malignant from benign parotid gland tumors. Eur Arch Otorhinolaryngol 275, 2151–2157 (2018). https://doi.org/10.1007/s00405-018-5052-y

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  • DOI: https://doi.org/10.1007/s00405-018-5052-y

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