title: Feasibility and value of quantitative dynamic contrast enhancement MR imaging in the evaluation of sinonasal tumors.
abstract: BACKGROUND
  Quantitative dynamic contrast enhancement MR imaging (DCE-MRI), used to measure properties of tissue microvasculature and tumor angiogenesis, is a promising method for distinguishing benign and malignant tumors and characterizing tumor response to antiangiogenic treatment. The aim of this study was to assess the feasibility of quantitative parameters derived from clinically used DCE-MRI for distinguishing benign from malignant tumors in the sinonasal area, which may be potentially useful for prediction and monitoring of treatment response to chemoradiotherapy of sinonasal tumors.
  
  
  METHODS
  One hundred and forty-three patients with sinonasal tumors, including 78 malignant tumors and 65 benign tumors and tumor-like lesions, underwent clinically used DCE-MRI. Parametric maps were obtained for quantitative parameters including K(trans), kep and ve. Two radiologists reviewed these maps and measured K(trans), kep and ve in the tumor tissue. Data were analyzed using independent T-test or Mann-Whitney U test analysis and receiver operating characteristic curves.
  
  
  RESULTS
  K(trans), kep and ve showed significant differences between benign and malignant tumors in the sinonasal area (P = 0.000 1). The accuracy of K(trans), kep and ve in differentiation between benign and malignant sinonasal tumors were 72.0%, 76.2% and 67.1%, respectively. There were significant differences in kep and ve between malignant epithelial sinonasal tumors and lymphomas (P < 0.05). Using a ve value of 0.213 as the threshold value differentiated malignant epithelial tumors from lymphomas with an accuracy of 78.3%, sensitivity of 88.2%, specificity of 68.0%, positive predictive value of 66.7%, and negative predictive value of 90.9%. However, no significant difference in K(trans) and kep was found between malignant epithelial and non-epithelial tumors in the sinonasal area (P > 0.05).
  
  
  CONCLUSIONS
  It is feasible that quantitative parameters of tumors can be derived from clinically used DCE-MRI in the sinonasal region. Preliminary findings suggest an increased value for quantitative DCE-MRI in the evaluation of sinonasal tumors in clinical practice.
authors.affiliation: Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Beijing Key Laboratory of Nasal Diseases, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
authors.forename: Junfang
authors.initials: J
authors.lastname: Xian
authors.affiliation: College of Engineering, Peking University, Beijing 100871, China.
authors.forename: Huarui
authors.initials: H
authors.lastname: Du
authors.affiliation: Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
authors.forename: Xinyan
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Yan
authors.affiliation: Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
authors.forename: Zhengyu
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Hao
authors.affiliation: Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Zhao
authors.affiliation: Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
authors.forename: Yajian
authors.initials: Y
authors.lastname: Tong
authors.affiliation: College of Engineering, Peking University, Beijing 100871, China.
authors.forename: Jue
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China. Email: zhangjue@pku.edu.cn.
authors.forename: Demin
authors.initials: D
authors.lastname: Han
mesh_terms: D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010255:Paranasal Sinus Neoplasms / Q000175:diagnosis*
chemical_list: D003287:Contrast Media