Qualitative Heterogeneous Signal Drop on Chemical Shift (CS) MR Imaging: Correlative Quantitative Analysis between CS Signal Intensity Index and Contrast Washout Parameters Using T1-Weighted Sequences
Arnaldo Stanzione,
Francesco Verde,
Roberta Galatola,
Valeria Romeo,
Raffaele Liuzzi,
Pier Paolo Mainenti,
Giovanni Aprea,
Michele Klain,
Elia Guadagno,
Marialaura Del Basso De Caro,
Simone Maurea
Affiliations
Arnaldo Stanzione
Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy
Francesco Verde
Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy
Roberta Galatola
Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy
Valeria Romeo
Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy
Raffaele Liuzzi
Institute of Biostructures and Bioimaging, The National Research Council (CNR), 80131 Naples, Italy
Pier Paolo Mainenti
Institute of Biostructures and Bioimaging, The National Research Council (CNR), 80131 Naples, Italy
Giovanni Aprea
Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy
Michele Klain
Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy
Elia Guadagno
Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy
Marialaura Del Basso De Caro
Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy
Simone Maurea
Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy
The aim of this study was to calculate MRI quantitative parameters extracted from chemical-shift (CS) and dynamic contrast-enhanced (DCE) T1-weighted (T1-WS) images of adrenal lesions (AL) with qualitative heterogeneous signal drop on CS T1-WS and compare them to those of AL with homogeneous or no signal drop on CS T1-WS. On 3 T MRI, 65 patients with a total of 72 AL were studied. CS images were qualitatively assessed for grouping AL as showing homogeneous (Group 1, n = 19), heterogeneous (Group 2, n = 23), and no (Group 3, n = 30) signal drop. Histopathology or follow-up data served as reference standard to classify AL. ROIs were drawn both on CS and DCE images to obtain adrenal CS signal intensity index (ASII), absolute (AWO), and relative washout (RWO) values. Quantitative parameters (QP) were compared with ANOVA analysis and post hoc Dunn’s test. The performance of QP to classify AL was assessed with receiver operating characteristic analysis. CS ASII values were significantly different among the three groups (p p < 0.001) lower in Group 3 (20 benign AL and 10 malignant AL). With cut-offs, respectively, of 60% (Group 1 vs. 2), 20% (Group 2 vs. 3), and 37% (Group 1 vs. 3), CS ASII showed areas under the curve of 0.85, 0.96, and 0.93 for the classification of AL, overall higher than AWO/RWO. In conclusion, AL with qualitative heterogeneous signal drop at CS represent benign AL with QP by DCE sequence similar to those of AL with homogeneous signal drop at CS, but different to those of AL with no signal drop at CS; ASII seems to be the only quantitative parameter able to differentiate AL among the three different groups.