Differentiation of olfactory neuroblastomas from nasal squamous cell carcinomas using MR diffusion kurtosis imaging and dynamic contrast-enhanced MRI.

PURPOSE To evaluate the use of magnetic resonance (MR) diffusion kurtosis imaging (DKI) and dynamic contrast-enhanced MR imaging (DCE-MRI) in the differentiation of olfactory neuroblastomas (ONBs) from squamous cell carcinomas (SCCs). MATERIALS AND METHODS DKI and DCE-MRI were performed in 17 patients with ONBs and 23 patients with SCCs on a 3T MR scanner. Parameters derived from DKI and DCE-MRI were measured and compared between ONBs and SCCs using an independent samples t-test. The sensitivity, specificity, accuracy, positive predictive values (PPV), negative predictive values (NPV), and the area under the receiver operating characteristic (ROC) curve were determined. RESULTS The mean kurtosis (K) value of ONBs was significantly higher than that of SCCs (P < 0.001), and the mean fractional volume in the extravascular extracellular space (Ve ) value of ONBs was lower than that of SCCs (P < 0.001). The ROC curve analyses yielded a cutoff K value of 0.953, with a sensitivity of 94.1%, a specificity of 69.6%, and an accuracy of 80.0%; the cutoff Ve value was 0.493, with a sensitivity of 70.6%, a specificity of 95.7%, and an accuracy of 85.0%. A parallel test with K value >0.953 or Ve value ≤0.493 achieved a sensitivity of 94.1%, a specificity of 100.0%, and an accuracy of 97.5% for differentiating ONBs from SCCs. CONCLUSION The K value of DKI and Ve value of DCE-MRI have potential use in the differentiation of ONBs and SCCs. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:354-361.