RT Journal Article
SR Electronic
T1 Dynamic Contrast-Enhanced MRI to Differentiate Parotid Neoplasms Using Golden-Angle Radial Sparse Parallel Imaging
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1029
OP 1036
DO 10.3174/ajnr.A6055
VO 40
IS 6
A1 Mogen, J.L.
A1 Block, K.T.
A1 Bansal, N.K.
A1 Patrie, J.T.
A1 Mukherjee, S.
A1 Zan, E.
A1 Hagiwara, M.
A1 Fatterpekar, G.M.
A1 Patel, S.H.
YR 2019
UL http://www.ajnr.org/content/40/6/1029.abstract
AB BACKGROUND AND PURPOSE: Conventional imaging frequently shows overlapping features between benign and malignant parotid neoplasms. We investigated dynamic contrast-enhanced MR imaging using golden-angle radial sparse parallel imaging in differentiating parotid neoplasms.MATERIALS AND METHODS: For this retrospective study, 41 consecutive parotid neoplasms were imaged with dynamic contrast-enhanced MR imaging with golden-angle radial sparse parallel imaging using 1-mm in-plane resolution. The temporal resolution was 3.4 seconds for 78.2 seconds and 8.8 seconds for the remaining acquisition. Three readers retrospectively and independently created and classified time-intensity curves as follows: 1) continuous wash-in; 2) rapid wash-in, subsequent plateau; and 3) rapid wash-in with washout. Additionally, time-intensity curve–derived semiquantitative metrics normalized to the ipsilateral common carotid artery were recorded. Diagnostic performance for the prediction of neoplasm type and malignancy was assessed. Subset multivariate analysis (n = 32) combined semiquantitative time-intensity curve metrics with ADC values.RESULTS: Independent time-intensity curve classification of the 41 neoplasms produced moderate-to-substantial interreader agreement (κ = 0.50–0.79). The time-intensity curve classification threshold of ≥2 predicted malignancy with a positive predictive value of 56.0%–66.7%, and a negative predictive value of 92.0%–100%. The time-intensity curve classification threshold of <2 predicted pleomorphic adenoma with a positive predictive value of 87.0%–95.0% and a negative predictive value of 76.0%–95.0%. For all readers, type 2 and 3 curves were associated with malignant neoplasms (P < .001), and type 1 curves, with pleomorphic adenomas (P < .001). Semiquantitative analysis for malignancy prediction yielded an area under the receiver operating characteristic curve of 0.85 (95% CI, 0.73–0.99). Combining time-to-maximum and ADC predicts pleomorphic adenoma better than either metric alone (P < .001).CONCLUSIONS: Golden-angle radial sparse parallel MR imaging allows high spatial and temporal resolution permeability characterization of parotid neoplasms, with a high negative predictive value for malignancy prediction. Combining time-to-maximum and ADC improves pleomorphic adenoma prediction compared with either metric alone.AUCarea under the curveDCEdynamic contrast-enhancedGRASPgolden-angle radial sparse parallelNPVnegative predictive valuePPVpositive predictive valueROCreceiver operating characteristicSImaxmaximum signal intensityTICtime-intensity curveTmaxtime-to-maximum