Effects of region of interest sizes on apparent diffusion coefficient measurements of pleomorphic adenoma, Warthin tumor, and normal parotid parenchyma

doi:10.19438/j.cjoms.2021.01.006

Abstract

Abstract: PURPOSE: Tumor apparent diffusion coefficient (ADC) measurements may be influenced by region of interest (ROI) sizes; however, this effect has not been systematically studied in parotid tumors. The purpose of this study was to determine the effects of ROI size on ADC measurements for differentiation of pleomorphic adenoma (PA), Warthin tumor (WT), and normal parotid parenchyma. METHODS: Sixty-five patients including 37 with PA (lesions, n=37) and 28 with WT (lesions, n=37) were examined with diffusion-weighted imaging (DWI). Participants with normal contralateral parenchyma of the parotid gland comprised the control group (n=56). The mean ADC values and standard deviations (SD) of the ADC (ADC_SD) of 12 concentric round ROIs (areas: 9, 28, 34, 50, 60, 82, 93, 98, 115, 130, 136, and 149 mm²) for tumors and normal tissue were measured by using custom-made software. Homogeneity index that was defined by the ADC_SD/mean ADC was also calculated. One-way repeated analyses of variance (ANOVA) was performed on the mean ADCs, ADC_SD and homogeneity indices of the 12 ROIs in each group. The three parameters at different ROIs among PA, WT and normal parotid parenchyma were compared using Kruska-Wallis tests with Medcalc software. RESULTS: Excellent agreement was achieved for ADC measurements with 12 ROIs for PA (ICC, 0.98), WT (ICC, 0.99) or normal parotid parenchyma (ICC, 0.95). No significant difference was observed in the mean ADCs of 12 ROIs for each of the three groups (P>0.05). Among the three groups, the mean ADC of normal parotid parenchyma[(0.94±0.003) ×10^-3 mm²/s] was significantly lower than that of both PA [(1.72±0.01)×10^-3 mm²/s] and WT [(1.16±0.01)×10^-3 mm²/s] in 12 ROIs, whereas PA group had the highest mean ADC values. No significant difference was found in the mean ADC_SD with each ROI between PA and WT (P>0.017). PAs had significantly lower homogeneity indices compared with WTs and normal parotid parenchyma(P<0.01). CONCLUSIONS: The effect of ROI size on ADC measurements could be excluded from the differentiation of PA, WT, and normal parotid parenchyma. Homogeneity index was a useful parameter in discriminating the three groups.

Key words: Diffusion weighted imaging, ADC, Region of interest, Pleomorphic adenoma, Warthin tumor

CLC Number:

R739.8

SUN Qi, MA Chao, DONG Min-jun, TAO Xiao-feng. Effects of region of interest sizes on apparent diffusion coefficient measurements of pleomorphic adenoma, Warthin tumor, and normal parotid parenchyma[J]. China Journal of Oral and Maxillofacial Surgery, 2021, 19(1): 29-35.

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