The Value of Multiparametric Magnetic Resonance Imaging in the Preoperative Differential Diagnosis of Parotid Gland Tumors

SIMPLE SUMMARY: An accurate preoperative diagnosis of parotid gland tumors is of paramount importance in selecting the surgical strategy. The aim of the study was to determine the value of multiparametric MRI in the preoperative diagnosis of parotid tumors. We confirmed that T2WI and ADC showed statistically significant differences in the differential diagnosis of benign from malignant tumors. Multiparametric MRI showed a sensitivity, specificity, and accuracy of 81.8%, 88.6%, and 92.3%, respectively. All of the studied parameters were statistically significant in the differentiation of pleomorphic adenomas from Warthin tumors. With reference to the scope of this study, the conjunction of multiparametric and conventional MRI demonstrated a sensitivity, specificity, and accuracy of 94.1%, 100%, and 97.8%, respectively. Conventional MRl combined with diffusion-weighted imaging (DWI) and dynamic contrast–enhanced (DCE) multiparametric MRI improved the preoperative differential diagnosis of parotid gland tumors. ABSTRACT: Background: The aim of the present study was to determine the value of multiparametric MRI in the preoperative differential diagnosis of parotid tumors, which is essential for therapeutic strategy selection. Methods: A three-year prospective study was conducted with 65 patients. Each patient was investigated preoperatively with multiparametric MRI and surgical excision of the tumor was performed. The preoperative imaging diagnosis was compared with the histopathological report. Several MRI parameters were analyzed, including T1 and T2 weighted image (WI), apparent diffusion coefficient (ADC), time to peak (TTP), and the time intensity curve (TIC). Results: In the differential diagnosis of benign from malignant tumors, T2WI and ADC showed statistically significant differences. Multiparametric MRI had a sensitivity, specificity, and accuracy of 81.8%, 88.6% and 92.3%, respectively. All of the studied parameters (T1, T2, TIC, TTP, ADC) were significantly different in the comparison between pleomorphic adenomas and Warthin tumors. With reference to the scope of this study, the conjunction of multiparametric and conventional MRI demonstrated a sensitivity, specificity, and accuracy of 94.1%, 100%, and 97.8%, respectively. Conclusions: Morphological analysis using conventional MRI combined with diffusion-weighted imaging (DW) and dynamic contrast–enhanced (DCE) multiparametric MRI improved the preoperative differential diagnosis of parotid gland tumors.