Article Figures & Data
Figures
- Fig 1.
Differences in ADC levels of the parotid, submandibular, and sublingual glands. Graph (box plots) shows ADC levels of parotid (PG), submandibular (SMG), and sublingual (SLG) glands. The horizontal line in each box is a median (50th percentile) of the measured values, the top and bottom of the boxes represent 25th and 75th percentiles, respectively, and whiskers indicate the range from the largest to smallest observed data points within 1.5 interquartile range presented by the box. P, Mann-Whitney U test.
- Fig 2.
A 70-year-old man with pleomorphic adenoma of parotid gland. A, Axial T1-weighted (TR/TE = 426 ms/12 ms) image using 47-mm microscopy coil shows tumor (arrows) with homogeneous architectures and hypointense signals relative to gland.
B, Axial fat-suppressed T2-weighted (TR/TE = 4677 ms/80 ms) image using microscopy coil shows heterogeneous tumor (arrows).
C, Axial ADC map shows that tumor (indicated by white contour) contains central high ADC area and peripheral intermediate ADC area.
D and E, Photomicrographs show area with proliferating tumor cells (D) or large cyst (E). Original magnifications, 20× (D) and 10× (E). Hematoxylin-eosin staining.
- Fig 3.
A 55-year-old man with Warthin tumor of parotid gland. A, Axial T1-weighted (TR/TE = 426 ms/12 ms) image using 47-mm microscopy coil shows hypointense and homogeneous tumor (arrows).
B, Axial fat-suppressed T2-weighted (TR/TE = 4677 ms/80 ms) image using 47-mm microscopy coil shows roughly homogeneous tumor (arrow).
C, Axial ADC map shows high ADC areas in proximal half and low ADC areas in distal half of Warthin tumor.
D and E, Photomicrographs show lymphoid tumor area (D) and necrotic area (E). Original magnification, 20×. Hematoxylin-eosin staining.
- Fig 4.
A 68-year-old man with mucoepidermoid carcinoma of sublingual gland. A, Axial T1-weighted (TR/TE = 500 ms/15 ms) image using 110-mm surface coil shows homogeneous tumor (arrows) of sublingual gland.
B, Axial fat-suppressed T2-weighted (TR/TE = 4677 ms/80 ms) image using 110-mm surface coil shows homogeneous tumor (arrows).
C, Axial ADC map shows that major part of tumor is of low ADCs.
D and E, Photomicrographs show proliferation of polygonal, clear cancer cells (D) and cancer cell nests in attenuated fibrous connective tissues (E). Original magnifications, 20× (D) and 10× (E). Hematoxylin-eosin staining.
- Fig 5.
A 71-year-old man with adenocarcinoma of submandibular gland. A, Axial T1-weighted (TR/TE = 500 ms/15 ms) image using 110-mm surface coil shows homogeneous tumor (arrows) of submandibular gland.
B, Axial fat-suppressed T2-weighted (TR/TE = 4677/80) image using surface coil shows slightly heterogeneous tumor (arrows).
C, Axial ADC map shows speckled pattern of low and high ADCs in tumor.
D, Photomicrograph shows cancer cells proliferating in loose connective tissues. Original magnification, 20×. Hematoxylin- eosin staining.
- Fig 6.
A 56-year-old woman with malignant lymphoma of parotid gland. A, Axial gadolinium-enhanced fat-suppressed T1-weighted image (TR/TE = 426 ms/12 ms) using 47-mm microscopy coil shows homogeneous lymphoma (arrows) of superficial part of gland.
B, Axial ADC map shows lymphoma having low ADCs throughout lesion.
C, Photomicrograph shows lymphoma cell proliferation (B cell, medium-sized cell type) associated with germ center-like structure. Original magnification, 20×. Hematoxylin-eosin staining.
Tables
Diagnosis No. of Patients ADCs (× 10−3 mm2/s) Extremely Low Low Intermediate High Benign 22 23 ± 26 13 ± 11 33 ± 21 30 ± 23* Pleomorphic adenoma 11 0 1 45 54 Warthin tumor 10 50 22 20 8 Papillary cystadenoma 1 0 9 64 28 Malignant 9 36 ± 41 41 ± 32 20 ± 19 4 ± 8* Mucoepidermoid carcinoma 2 9 77 14 0 Adenoid cystic carcinoma 2 11 74 13 3 Salivary duct carcinoma 1 10 64 26 0 Adenocarcinoma 1 24 42 32 3 Lymphoma 2 98 2 0 0 Carcinoma ex pleomorphic adenoma 1 5 35 38 22 Note:—ADC indicates apparent diffusion coefficient.
Data are proportions of each of the areas having an indicated ADC level relative to the maximum tumor area on ADC maps and are expressed as means or means ± S.E.
* Statistically significant (P < 0.001, Mann-Whitney U test).
Diagnostic Ability Cutoff Points of Percentage Area Having High ADCs for the Diagnosis of Malignant Tumors <3% <5% <10% <15% Sensitivity (%) 56 89 89 89 Specificity (%) 100 100 73 59 Accuracy (%) 87 97 77 68 PPV (%) 100 100 100 100 NPV (%) 85 96 70 57 Note:—PPV indicates positive predictive value; NPV, negative predictive value.
On the ADC map image that demonstrates the maximum tumor area of a salivary gland tumor, diagnostic abilities for the diagnosis of malignant tumors were calculated after varying the cutoff point of percentage area having high ADCs (≥1.8 × 10−3 mm2/s).
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