Precise differentiation between jugular foramen paragangliomas and metastases: utility of diffusion-weighted and dynamic contrast-enhanced magnetic resonance imaging.

Purpose: This study tested the utility of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced imaging (DCE-MRI) in differentiating paragangliomas and metastases in the jugular foramen in combination with conventional imaging. Methods: Forty-nine consecutive patients with paragangliomas or...

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Publicado en:Neuroradiology Vol. 65; no. 4; pp. 805 - 814
Autores principales: Ota, Yoshiaki, Curaudeau, Guillaume, Liao, Eric, Bapuraj, Jayapalli, Baba, Akira, Shah, Gaurang, Srinivasan, Ashok
Formato: diagnostic images research tables/charts Journal Article
Publicado: Springer Nature Apr2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2023
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        10.1007/s00234-023-03113-0
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        atl: Precise differentiation between jugular foramen paragangliomas and metastases: utility of diffusion-weighted and dynamic contrast-enhanced magnetic resonance imaging.
      aug:
        au:
          Ota, Yoshiaki
          Curaudeau, Guillaume
          Liao, Eric
          Bapuraj, Jayapalli
          Baba, Akira
          Shah, Gaurang
          Srinivasan, Ashok
        affil: Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, 48109, Ann Arbor, MI, USA
      sug:
        subj:
          Magnetic Resonance Imaging Methods
          Paraganglioma Diagnosis
          Neoplasm Metastasis
          Jugular Foramen Pathology
          Contrast Media
          Sensitivity and Specificity
          Human
          Male
          Female
          Adult
          Middle Age
          Aged
          Retrospective Design
          ROC Curve
          Descriptive Statistics
          Comparative Studies
          Lung Neoplasms
          Breast Neoplasms
          Melanoma
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Purpose: This study tested the utility of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced imaging (DCE-MRI) in differentiating paragangliomas and metastases in the jugular foramen in combination with conventional imaging. Methods: Forty-nine consecutive patients with paragangliomas or metastases between January 2015 and April 2022 were included in this retrospective study. All patients had pretreatment DWI and DCE-MRI. Between paragangliomas and metastases, normalized apparent diffusion coefficient (nADCmean) and DCE-MRI parameters were compared along with conventional imaging features (enhancement pattern, presence of flow voids, cystic/necrotic change, and bone erosion). The diagnostic performance was tested using receiver operating characteristic (ROC) analysis. Results: Thirty-five paragangliomas (5 male; median 49 years) and 14 metastases (9 male; median 61 years) were analyzed. The most common 3 primary cancers included 4 lung cancers, 3 breast cancers, and 3 melanomas. The presence of flow void was significantly different between paragangliomas and metastases (21/35 vs 2/14; P = 0.0047) in conventional imaging features, while fractional plasma volume (Vp) was significantly different between the two tumor types (median 0.46 vs 0.19; P < 0.001) in DWI and DCE-MRI parameters. The areas under the ROC curves (AUCs) of the presence of flow void and Vp were 0.72 and 0.93, respectively. The AUC of the combination of the presence of flow void and Vp was 0.95 and significantly improved compared to that of the presence of flow void (P < 0.001). Conclusion: Adding DCE-MRI to the head and neck protocol can aid in the precise differentiation between jugular foramen paragangliomas and metastases.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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