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Salivary Gland Tumors: Diagnostic Value of Gadolinium-enhanced Dynamic MR Imaging with Histopathologic Correlation¹

¹ From the Departments of Radiology (H.Y., T.F., T.T., M.K.), Pathology (Y.H.), and Head and Neck Surgery (K.T.), National Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka 811-1395, Japan. From the 2000 RSNA scientific assembly. Received September 5, 2001; revision requested October 16; final revision received July 10, 2002; accepted July 31. Address correspondence to H.Y. (e-mail: hyabuu@nk-cc.go.jp).

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 to determine whether any differences among the various histopathologic tumor types existed. 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, = -0.800) and between WR and cellularity-stromal grade (P = .0105, = 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.

© RSNA, 2003

Index terms: Magnetic resonance (MR), contrast enhancement, 264.121411, 264.121416, 264.12143 • Salivary glands, MR, 264.121411, 264.121416, 264.12143 • Salivary glands, neoplasms, 264.343, 264.363, 264.373

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