Amide proton transfer-weighted magnetic resonance imaging for the differentiation of parotid gland tumors

Yihua Wang; Lijun Wang; Haitao Huang; Juntao Ma; Liangjie Lin; Lin Liu; Qingwei Song; Ailian Liu

doi:10.3389/fonc.2023.1223598

Amide proton transfer-weighted magnetic resonance imaging for the differentiation of parotid gland tumors

Front Oncol. 2023 Aug 18:13:1223598. doi: 10.3389/fonc.2023.1223598. eCollection 2023.

Authors

Yihua Wang¹, Lijun Wang¹, Haitao Huang², Juntao Ma², Liangjie Lin³, Lin Liu², Qingwei Song¹, Ailian Liu¹

Affiliations

¹ Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China.
² Department of Stomatology, First Affiliated Hospital of Dalian Medical University, Dalian, China.
³ Clinical and Technical Support, Philips Healthcare, Beijing, China.

Abstract

Purpose: To assess the usefulness of amide proton transfer-weighted (APTw) imaging in the differentiation of parotid gland tumors.

Materials and methods: Patients with parotid gland tumors who underwent APTw imaging were retrospectively enrolled and divided into groups according to pathology. Two radiologists evaluated the APTw image quality independently, and APTw images with quality score ≥3 were enrolled. The maximum and average values of APTw imaging for tumor lesions (APTmax and APTmean) were measured. The differences in APTmax and APTmean were compared between malignant tumors (MTs) and benign tumors (BTs), as well as between MTs and pleomorphic adenomas (PAs) and between MTs and Warthin tumors (WTs). Independent-samples t-test, Kruskal-Wallis H test, and receiver operating characteristic (ROC) curve analyses were used for statistical analysis.

Results: Seventy-three patients were included for image quality evaluation. In this study, 32/73 and 29/73 parotid tumors were scored as 4 and 3, respectively. After excluding lesions with quality score ≤2 (12/73), the APTmean and APTmax of MTs were 4.15% ± 1.33% and 7.43% ± 1.61%, higher than those of BTs 2.74% ± 1.04% and 5.25% ± 1.54%, respectively (p < 0.05). The areas under the ROC curve (AUCs) of the APTmean and APTmax for differentiation between MTs and BTs were 0.819 and 0.821, respectively. MTs indicated significantly higher APTmean and APTmax values than those of PAs (p < 0.05) and WTs (p < 0.05). The AUCs of the APTmean and APTmax for differentiation between MTs and PAs were 0.830 and 0.815 and between MTs and WTs were 0.847 and 0.920, respectively.

Conclusion: Most APTw images for parotid tumors had acceptable image quality for APTw value evaluation. Both APTmax and APTmean can be used to differentiate MTs from BTs and to differentiate MTs from subtype parotid gland tumors.

Keywords: Warthin tumor; amide proton transfer-weighted image; magnetic resonance imaging; parotid gland tumor; pleomorphic adenoma.

Grants and funding

This study was supported by the Medical Education Research Project of Liaoning Province (No. 2022-N005-05).