Synthetic MRI in differentiating benign from metastatic retropharyngeal lymph node: combination with diffusion-weighted imaging

Peng Wang; Shudong Hu; Xiuyu Wang; Yuxi Ge; Jing Zhao; Hongyan Qiao; Jun Chang; Weiqiang Dou; Heng Zhang

doi:10.1007/s00330-022-09027-4

Synthetic MRI in differentiating benign from metastatic retropharyngeal lymph node: combination with diffusion-weighted imaging

Eur Radiol. 2023 Jan;33(1):152-161. doi: 10.1007/s00330-022-09027-4. Epub 2022 Aug 11.

Authors

Peng Wang¹, Shudong Hu¹, Xiuyu Wang¹, Yuxi Ge¹, Jing Zhao¹, Hongyan Qiao¹, Jun Chang¹, Weiqiang Dou², Heng Zhang³

Affiliations

¹ Department of Radiology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214122, People's Republic of China.
² GE Healthcare, MR Research China, Beijing, 100176, People's Republic of China.
³ Department of Radiology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214122, People's Republic of China. qingfengplayer@163.com.

PMID: 35951044
DOI: 10.1007/s00330-022-09027-4

Abstract

Objectives: This study aimed to evaluate the synthetic MRI (syMRI), its combination with diffusion-weighted imaging (DWI), and morphological features for discriminating benign from metastatic retropharyngeal lymph nodes (RLNs).

Methods: Fifty-eight patients with a total of 63 RLNs (21 benign and 42 metastatic) were enrolled. The mean and standard deviation of syMRI-derived relaxometry parameters (T1, T2, PD; T1_SD, T2_SD, PD_SD) were obtained from two different regions of interest (namely, partial-lesion and full-lesion ROI). The parameters derived from benign and metastatic RLNs were compared using Student's t or chi-square tests. Logistic regression analysis was used to construct a multi-parameter model of syMRI, syMRI + DWI, and syMRI + DWI + morphological features. Areas under the curve (AUC) were compared using the DeLong test to determine the best diagnostic approach.

Results: Benign RLNs had significantly higher T1, T2, PD, and T1_SD values compared with metastatic RLNs in both partial-lesion and full-lesion ROI (all p < 0.05). The T1_SD obtained from full-lesion ROI showed the best diagnostic performance among all syMRI-derived single parameters. The AUC of combined syMRI multiple parameters (T1, T2, PD, T1_SD) were higher than those of any single parameter from syMRI. The combination of synthetic MRI and DWI can improve the AUC regardless of ROI delineation. Furthermore, the combination of synthetic MRI, DWI-derived quantitative parameters, and morphological features can significantly improve the overall diagnostic performance.

Conclusions: The value of syMRI has been validated in differential diagnosis of benign and metastatic RLNs, and syMRI + DWI + morphological features can further improve the diagnostic efficiency for discriminating these two entities.

Key points: • Synthetic MRI was useful in differential diagnosis of benign and metastatic RLNs. • The combination of syMRI, DWI, and morphological features can significantly improve the diagnostic efficiency.

Keywords: Diffusion magnetic resonance imaging; Head and neck neoplasms; Nasopharyngeal carcinoma.

MeSH terms

Diagnosis, Differential
Diffusion Magnetic Resonance Imaging* / methods
Humans
Lymph Nodes* / diagnostic imaging
Lymph Nodes* / pathology
Lymphatic Metastasis / diagnostic imaging
Lymphatic Metastasis / pathology
Magnetic Resonance Imaging / methods
Neck
Sensitivity and Specificity