Multiparametric approach with synthetic MR imaging for diagnosing salivary gland lesions

Abstract Purpose To determine whether synthetic MR imaging can distinguish between benign and malignant salivary gland lesions. Methods The study population included 44 patients with 33 benign and 11 malignant salivary gland lesions. All MR imaging was obtained using a 3 Tesla system. The QRAPMASTER pulse sequence was used to acquire images with four TI values and two TE values, from which quantitative images of T1 and T2 relaxation times and proton density (PD) were generated. The Mann–Whitney U test was used to compare T1, T2, PD, and ADC values among the subtypes of salivary gland lesions. ROC analysis was used to evaluate diagnostic capability between malignant tumors (MTs) and either pleomorphic adenomas (PAs) or Warthin tumors (WTs). We further calculated diagnostic accuracy for distinguishing malignant from benign lesions when combining these parameters. Results PAs demonstrated significantly higher T1, T2, PD, and ADC values than WTs (all p < 0.001). Compared to MTs, PAs had significantly higher T1, T2, and ADC values (all p < 0.001), whereas WTs had significantly lower T1, T2, and PD values ( p < 0.001, p = 0.008, and p = 0.003, respectively). T2 and ADC were most effective in differentiating between MTs and PAs (AUC = 0.928 and 0.939, respectively), and T1 and PD values for differentiating between MTs and WTs (AUC = 0.915 and 0.833, respectively). Combining T1 with T2 or ADC achieved accuracy of 86.4% in distinguishing between malignant and benign tumors. Similarly, combining PD with T2 or ADC reached accuracy of 86.4% for differentiating between malignant and benign tumors. Conclusions Utilizing a combination of synthetic MRI parameters may assist in differentiating malignant from benign salivary gland lesions.