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  • Title: Differential diagnosis of nasopharyngeal carcinoma and nasopharyngeal lymphoma based on DCE-MRI and RESOLVE-DWI.
    Author: Song C, Cheng P, Cheng J, Zhang Y, Sun M, Xie S, Zhang X.
    Journal: Eur Radiol; 2020 Jan; 30(1):110-118. PubMed ID: 31372786.
    Abstract:
    OBJECTIVES: To explore the utility of dynamic contrast-enhanced MRI (DCE-MRI) and readout-segmented diffusion-weighted imaging (RESOLVE-DWI) in the differentiation of nasopharyngeal carcinoma (NPC) and nasopharyngeal lymphoma (NPL). METHODS: Sixty-two patients with NPC and 39 patients with NPL who underwent DCE-MRI and RESOLVE-DWI examinations were evaluated. The time signal-intensity curve (TIC) types, time to peak (TTP), enhancement peak (EP), maximum contrast enhancement ratio (MCER), washout ratio (WR), apparent diffusion coefficient (ADC), and relative ADC (rADC) values were calculated. Statistical analysis between the two groups was performed to determine the statistical significance of each parameter. Receiver operating characteristic (ROC) curve analysis and binary logistic regression analysis were used to assess the diagnostic ability of single and combined metrics for distinguishing NPC from NPL. RESULTS: The most common TIC curve was type III in patients with NPC (n = 26), while the majority of the curves were types I (n = 14) and II (n = 19) in patients with NPL. TTP, EP, MCER, ADC, and rADC were statistically significantly different between NPCs and NPLs (p < 0.05). Among these factors, ADC revealed the most reliable diagnostic performance, followed by rADC, TTP, MCER, and EP. Moreover, the diagnostic efficiency of the combined DCE-MRI parameters was higher than that of TTP, MCER, and EP each alone. In addition, the combination of all DCE-MRI and DWI parameters together demonstrated the highest diagnostic efficiency (area under the curve = 0.961). However, none of the parameters was significantly different between keratinising NPC and non-keratinising NPC or between NK/T lymphoma and diffuse large B cell lymphoma (all p > 0.05). CONCLUSION: DCE-MRI and RESOLVE-DWI are effective in differentiating NPC from NPL. KEY POINTS: • RESOLVE offers high image quality in the head and neck regions. • Dynamic contrast-enhanced MRI and RESOLVE-DWI help clinicians to make the differential diagnosis between NPC and NPL. • The combination of all the DCE-MRI and DWI parameters together demonstrated the highest diagnostic efficiency compared with each parameter alone.
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