title: Dynamic contrast-enhanced MRI for differentiation of major salivary glands neoplasms, a 3-T MRI study.
abstract: OBJECTIVE
  Pre-operative differentiation of salivary gland neoplasms is of great importance. This study was designed to evaluate the use of dynamic contrast-enhanced MRI (DCE-MRI) for differentiation between malignant, Warthin and benign non-Warthin (BNW) neoplasms of major salivary glands.
  
  
  METHODS
  46 major salivary gland tumours (SGTs) underwent pre-operative DCE-MRI. Post-surgical histopathological evaluation showed 30 BNW, 6 Warthin and 10 malignant tumours. Time-signal intensity curves (TICs) were categorized as (a) Tpeak >43 s and washout ratio at 180 s (WR180) <4.6%; (b) Tpeak <43 s and WR >22%; (c) Tpeak >43 s and WR180 = 4.6-22.0%
  
  
  RESULTS
  Accuracy of Tpeak was 98.9% for differentiation between BNW and Warthin tumours, 83.7% between BNW and malignant and 80% between malignant and Warthin tumours. All Warthin tumours showed Tpeak ≤43 s, while one BNW had Tpeak <43 s. A Tpeak <63.5 s differentiated 8/10 (80%) malignant tumours from BNW tumours, whereas 4/30 of BNW tumours had a Tpeak <63.5 s. Two malignant tumours had Tpeak <43 s. WR180 had an accuracy of 100% for differentiation between Warthin and BNW tumours, 87.3% between BNW and malignant, and 93.3% between Warthin and malignant tumours. 29 (96.7%) BNW tumours had a washout <4.60%, while 8 (80%) malignant tumours had a washout >4.60%. All Warthin tumours had a WR180 >22%, while two malignant tumours had a WR180 >22%. 29/30 of BNW tumours demonstrated TIC curve Type A and 1 tumour demonstrated Type C. 6/10 of malignant tumours had TIC Type C, 2 had TIC Type A and 2 Type B. All Warthin tumours were categorized as Type B.
  
  
  CONCLUSIONS
  This study showed that DCE-MRI could be helpful in pre-operative differentiation of SGTs; especially for discrimination between Warthin and BNW tumours.
authors.affiliation: 1 Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: L
authors.initials: L
authors.lastname: Aghaghazvini
authors.forename: F
authors.initials: F
authors.lastname: Salahshour
authors.forename: N
authors.initials: N
authors.lastname: Yazdani
authors.forename: H
authors.initials: H
authors.lastname: Sharifian
authors.forename: S
authors.initials: S
authors.lastname: Kooraki
authors.forename: M
authors.initials: M
authors.lastname: Pakravan
authors.forename: M
authors.initials: M
authors.lastname: Shakiba
mesh_terms: D000235:Adenolymphoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003287:Contrast Media; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D012468:Salivary Gland Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA
keywords: dynamic MRI; neoplasm; salivary glands