Dynamic Contrast-Enhanced MRI Can Quantitatively Discriminate the Original Site From Peripheral Portion of Sinonasal Inverted Papillomas

Zheng Li; Mu Xian; Jian Guo; Xiaoxia Qu; Chengshuo Wang; Luo Zhang; Junfang Xian

doi:10.1002/jmri.27474

Dynamic Contrast-Enhanced MRI Can Quantitatively Discriminate the Original Site From Peripheral Portion of Sinonasal Inverted Papillomas

J Magn Reson Imaging. 2021 May;53(5):1522-1527. doi: 10.1002/jmri.27474. Epub 2020 Dec 26.

Authors

Zheng Li¹, Mu Xian², Jian Guo¹, Xiaoxia Qu¹, Chengshuo Wang², Luo Zhang², Junfang Xian¹

Affiliations

¹ Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
² Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

PMID: 33368767
DOI: 10.1002/jmri.27474

Abstract

Background: Identification of the original site of sinonasal inverted papillomas (SIPs) is difficult but essential for reducing the recurrence rate. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) may provide information about tissue perfusion and permeability to solve this problem.

Purpose: To investigate the accuracy of DCE-MRI parameters in discriminating between regions of interest (ROIs) in the original site and peripheral portion.

Study type: Retrospective.

Population: Ninety consecutive patients with pathologically proven SIP.

Field strength/sequence: 3.0T/DCE-MRI using fast-spoiled gradient recalled (FSPGR) T₁ -weighted images with fat saturation.

Assessment: ROIs were placed in the original site and the peripheral portion of SIP by two radiologists according to surgical records. Maximum slope of increase (MaxSlope), contrast-enhancement ratio (CER), bolus arrival time (BAT), initial area under the signal intensity-time curve (IAUGC), volume transfer constant (K^trans ), volume of the extravascular extracellular space (v_e ), and rate constant (K_ep ) were calculated and repeated again with a month interval by a radiologist.

Statistical tests: Univariate and multivariate analysis was used to determine the best diagnostic parameters, and their performances in discrimination were evaluated by receiver operating characteristic (ROC) curves. Reproducibility was estimated by the intraclass correlation coefficient (ICC).

Results: MaxSlope, CER, IAUGC, K^trans , and v_e were significantly lower (P < 0.05) in the original site than the peripheral portion of SIPs. CER (odds ratio [OR] = 0.227, 95% confidence interval [95% CI] = 0.073-0.704) and v_e (OR = 0.048, 95% CI = 0.004-0.527) were the best indicators for identifying the original ROIs. The combination of CER and v_e had the best diagnostic performance in the discrimination between the ROIs (the area under the curve [AUC]: 0.937; 95% CI: 0.896-0.974).

Data conclusion: DCE-MRI derived parameter values differed between the original site and the peripheral portion of SIPs. The model combining CER and v_e appears to be able to accurately distinguish the original from peripheral ROIs.

Level of evidence: 4 TECHNICAL EFFICACY STAGE: 2.

Keywords: diagnosis; inverted papilloma; magnetic resonance imaging; quantitative; sinonasal.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Contrast Media*
Humans
Magnetic Resonance Imaging
Neoplasm Recurrence, Local
Papilloma, Inverted* / diagnostic imaging
Reproducibility of Results
Retrospective Studies

Substances

Contrast Media