Salivary Gland Tumors: Diagnostic Value of Gadolinium-enhanced Dynamic MR Imaging with Histopathologic Correlation

Abstract

PURPOSE: To evaluate the diagnostic value of gadolinium-enhanced dynamic magnetic resonance (MR) imaging of salivary gland tumors and correlate the MR imaging and histopathologic findings. MATERIALS AND METHODS: Thirty-three salivary gland tumors in 29 patients were examined preoperatively at gadolinium-enhanced dynamic MR imaging. There were 22 benign and 11 malignant tumors. Dynamic contrast material-enhanced MR images were obtained for 5 minutes. Time of peak enhancement (T(peak)) and washout ratio (WR) were determined from time-signal intensity curves (TICs). Microvessel count and cellularity-stromal grade were evaluated histopathologically. The strengths of correlations between T(peak) and microvessel count and between WR and cellularity-stromal grade were statistically analyzed. Statistical analysis was also performed to determine whether any differences among the various histopathologic tumor types existed [corrected]. In a validation study, 13 salivary gland tumors in 13 patients were examined consecutively. RESULTS: At a T(peak) of 120 seconds, malignant tumors could be differentiated from pleomorphic adenomas but not from Warthin tumors. A WR of 30%, however, enabled differentiation between malignant and Warthin tumors. Classification of TICs on the basis of a T(peak) of 120 seconds and a WR of 30% had high sensitivity (91%) and specificity (91%) in the differentiation of benign and malignant tumors. Correlations between T(peak) and microvessel count (P <.0001, rho = -0.800) and between WR and cellularity-stromal grade (P =.0105, rho = 0.572) were significant. The validation study also yielded high sensitivity (100%) and specificity (80%) in the differentiation between benign and malignant tumors. CONCLUSION: Gadolinium-enhanced dynamic MR imaging is useful for differentiating benign from malignant salivary gland tumors.