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Benign and malignant orbital lymphoproliferative disorders: Differentiating using multiparametric MRI at 3.0T
Author(s) -
Xu XiaoQuan,
Hu Hao,
Liu Hu,
Wu JiangFen,
Cao Peng,
Shi HaiBin,
Wu FeiYun
Publication year - 2017
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.25349
Subject(s) - receiver operating characteristic , medicine , effective diffusion coefficient , magnetic resonance imaging , nuclear medicine , area under the curve , diffusion mri , logistic regression , lymphoproliferative disorders , radiology , pathology , lymphoma
Purpose To determine the optimal combination of parameters derived from 3T multiparametric (conventional magnetic resonance imaging [MRI], diffusion‐weighted [DW] and dynamic contrast‐enhanced [DCE]) MRI for differentiating malignant from benign orbital lymphoproliferative disorders (OLPDs). Materials and Methods Forty patients with OLPDs (18 benign and 22 malignant) underwent conventional 3.0T MR, DW, and DCE‐MRI examination for presurgery evaluation. Conventional MRI features (including tumor laterality, shape, number of involved quadrants, signal intensity on T 1 ‐weighted imaging (WI) and T 2 WI, flow void sign on T 2 WI, and findings suggestive of sinusitis) were reviewed, and multivariate logistic regression analysis was used to identify the most significant conventional MRI features. Apparent diffusion coefficient (ADC) and DCE‐MRI derived parameters (area under curve [AUC], time to peak [TTP], maximum rise slope [Slope max ]) were measured and compared between two groups. Receiver operating characteristic (ROC) curve analyses were used to determine the diagnostic ability of each combination that was established based on identified qualitative and quantitative parameters. Results Multivariate logistic regression analysis showed that the presence of flow void sign on T 2 WI significantly associated with benign OLPDs ( P = 0.034). Malignant OLPDs demonstrated significantly lower ADC ( P = 0.001) and AUC ( P = 0.002) than benign mimics. ROC analyses indicted that, ADC alone showed the optimal sensitivity (threshold value, 0.886 × 10 −3 mm 2 /s; sensitivity, 90.9%), while a combination of no presence of flow void sign on T 2 WI + ADC ≤ 0.886 × 10 −3 mm 2 /s + AUC ≤ 7.366 showed optimal specificity (88.9%) in differentiating benign from malignant OLPDs. Conclusion Multiparametric MRI can help to differentiate malignant from benign OLPDs. DWI offers optimal sensitivity, while the combination of conventional MRI, DWI, and DCE‐MRI offers optimal specificity. Level of Evidence: 3 J. Magn. Reson. Imaging 2017;45:167–176.