Objectives: The aim of this study was to investigate the relationship between pathological classification of parotid gland tumors and conventional MRI – diffusion-weighted imaging findings and also contribute the possible effect of apparent diffusion coefficient (ADC) to diagnosis. Methods: 60 patients with parotid masses diagnosed using histopathology and/or cytology were enrolled in this retrospective study. All patients were evaluated using a 1.5 T MRI. Demographic features, conventional MRI findings, and ADC values (mean, minimum, maximum, and relative) were recorded. MRI findings and ADC values were compared between benign–malignant groups and pleomorphic adenoma vs Warthin’s tumor groups. Results: 60 tumors (48 benign, 12 malignant) were evaluated in a total of 60 patients (39 males, 21 females). The mean age was 59 (±14, 18–86) years old; the mean lesion size was 26 (±10, 11–61) mm. On the texture of conventional MRI, T2 dominantly hyperintense/with hypointensity signal was seen in 87% of pleomorphic adenomas and T2 dominantly hypointense/with hyperintesity signal was encountered in 64% of all Warthin’s tumors. Seven (28%) Warthin’s tumors were misdiagnosed as pleomorphic adenomas and two others (8%) as malignant tumors. The commonly used mean ADC value was 1.6 ± 0.6 × 10^–3 mm² s⁻¹ for benign tumors, 0.8 ± 0.3 × 10^–3 mm² s⁻¹ for malign tumors, 1 (0.9–1.8) × 10^–3 mm² s⁻¹ for Warthin’s tumors, and 1.9 ± 0.3 × 10^–3 mm² s⁻¹ for pleomorphic adenomas. There was a statistically significant difference in ADC values between benign-malignant tumors and pleomorphic adenomas-Warthin’s tumors. Conclusions: Warthin’s tumor may occasionally be misdiagnosed as pleomorphic adenoma and malignant tumor because of variable morphologic features. In addition to benign–malignant differentiation, the added ADC measurement may also be useful for differentiating Warthin’s tumors from pleomorphic adenomas.

Diagnostic and Interventional Radiology

J Indian Prosthodont Soc, Official publication of Indian Prosthodontic Society

Dir Journal Diagnostic and Interventional Radiology

To investigate the potential diagnostic value of point shear wave elastography (pSWE) and the contribution of concurrent diffusion weighted magnetic resonance imaging (DW-MRI) to diagnostic performance in patients with cervical lymphadenopathy. This cross-sectional study included 116 cervical lymph nodes of 94 patients. All lymph nodes were evaluated before the treatment or histopathological sampling. Gray scale ultrasonographic features, elastographic stiffness and apparent diffusion coefficient (ADC) values were measured and recorded. Lymph nodes were divided into benign and malignant groups with histopathological findings. Short axis measurement, axis ratio, hilum morphology, vascularization patterns, pSWE, and ADC values were the most significant parameters in logistic regression tests. The median stiffness of malignant nodes was higher and the mean ADC values were lower than others. Also, lymphoproliferative disorders had the lowest ADC values (p < 0.001). Area under the curve values for pSWE and DW-MRI were 0.852 [95% confidence interval (CI), 0.779–0.925], 0.790 (95% CI, 0.695–0.885), respectively. The accuracy rate increased from 79.3% to 85.3% when the pSWE was combined with the ultrasonography (US). The use of pSWE combined with conventional US will reduce the number of biopsies and may be sufficient to differentiate the lymph nodes.