Value of quantitative multiparametric MRI in differentiating pleomorphic adenomas from malignant epithelial tumors in lacrimal gland

Purpose To evaluate the diagnostic performance of the quantitative parameters derived from diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) MRI in differentiating lacrimal gland pleomorphic adenomas (LGPAs) from lacrimal gland malignant epithelial tumors (LGMETs). Methods Seventy-seven cases with LG epithelial tumors confirmed by histopathology (47 LGPAs and 30 LGMETs) underwent DWI and DCE-MRI. The quantitative parameters including the apparent diffusion coefficient (ADC), the volume transfer constant (K-trans), the efflux rate constant from the extravascular extracellular space (EES) to blood plasma (K-ep), and the extravascular extracellular volume fraction (V-e) were used to differentiate LGPAs from LGMETs. Independent-samples t test was conducted to compare these parameters. The diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis. Results Compared with LGPAs, LGMETs had significantly lower ADC value (1.090 +/- 0.169mm(2)/s) (P < 0.001), higher K-trans value (0.892 +/- 0.517/min) (P = 0.001), and K-ep value (1.300 +/- 1.131/min) (P = 0.002). ADC as a diagnostic index showed a better diagnostic efficacy in predicting malignant tumors (AUC 0.914, sensitivity 90.0%, specificity 85.1%, and accuracy 87.0%) than K-trans and K-ep alone. The combination of ADC and K-trans presented the optimal diagnostic performance for the differentiation (AUC 0.938, sensitivity 93.3%, specificity 87.2%, accuracy 89.6%). Conclusion The quantitative parameters including ADC, K-trans, and K-ep derived from DWI and DCE-MRI might be potential imaging biomarkers in differentiating LGPAs from LGMETs. The combination of ADC and K-trans is superior to other quantitative parameters in distinguishing LGPAs from LGMETs.