{"title":"Role of resolve DWI and DCE MRI in differentiating benign and malignant skull base lesions.","authors":"Pradeep Mohanasundaram, Jyoti Kumar, Gaurav Shanker Pradhan, Daljit Singh, Ishwar Singh","doi":"10.1007/s00234-025-03760-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To assess the utility of RESOLVE Diffusion-Weighted Imaging (DWI) and Dynamic Contrast-Enhanced (DCE) MRI in differentiating benign and malignant skull base lesions using qualitative and quantitative imaging parameters.</p><p><strong>Methods: </strong>This prospective study included 44 patients with 45 skull base lesions who underwent MRI with RESOLVE DWI and DCE-MRI. Apparent diffusion coefficient (ADC) values and lesion-to-medulla ADC ratios were calculated from DWI. Perfusion parameters (Ktrans, Kep, Ve) and time-intensity curve (TIC) were derived from DCE-MRI. Benign and malignant lesions were statistically compared, and receiver operating characteristic analysis was performed to evaluate diagnostic capability.</p><p><strong>Results: </strong>Malignant lesions had significantly lower mean ADC values (0.88 × 10⁻³ mm²/s) than benign lesions (1.05 × 10⁻³ mm²/s, p = 0.033). The lesion-to-medulla ADC ratio was also significantly lower in malignant lesions (1.03 vs. 1.25, p = 0.029), yielding 89% sensitivity and 44% specificity at a cutoff ≤ 1.167 (AUC = 0.695). Among DCE-MRI parameters, both Kep and the distribution of time-intensity curve (TIC) showed significant differences between benign and malignant lesions (p = 0.037 and p < 0.001, respectively). Kep was higher in malignant lesions (0.98 vs. 0.78), with an AUC of 0.689, 94% sensitivity, and 52% specificity at a cutoff of ≥ 0.581. Ktrans and Ve did not show significant statistical difference.</p><p><strong>Conclusion: </strong>RESOLVE DWI and DCE-MRI are effective non-invasive tools for differentiating benign and malignant skull base lesions. The ADC ratio and Kep are valuable quantitative markers, while TIC pattern analysis offers complementary qualitative insights, enhancing diagnostic confidence.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuroradiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00234-025-03760-5","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: To assess the utility of RESOLVE Diffusion-Weighted Imaging (DWI) and Dynamic Contrast-Enhanced (DCE) MRI in differentiating benign and malignant skull base lesions using qualitative and quantitative imaging parameters.
Methods: This prospective study included 44 patients with 45 skull base lesions who underwent MRI with RESOLVE DWI and DCE-MRI. Apparent diffusion coefficient (ADC) values and lesion-to-medulla ADC ratios were calculated from DWI. Perfusion parameters (Ktrans, Kep, Ve) and time-intensity curve (TIC) were derived from DCE-MRI. Benign and malignant lesions were statistically compared, and receiver operating characteristic analysis was performed to evaluate diagnostic capability.
Results: Malignant lesions had significantly lower mean ADC values (0.88 × 10⁻³ mm²/s) than benign lesions (1.05 × 10⁻³ mm²/s, p = 0.033). The lesion-to-medulla ADC ratio was also significantly lower in malignant lesions (1.03 vs. 1.25, p = 0.029), yielding 89% sensitivity and 44% specificity at a cutoff ≤ 1.167 (AUC = 0.695). Among DCE-MRI parameters, both Kep and the distribution of time-intensity curve (TIC) showed significant differences between benign and malignant lesions (p = 0.037 and p < 0.001, respectively). Kep was higher in malignant lesions (0.98 vs. 0.78), with an AUC of 0.689, 94% sensitivity, and 52% specificity at a cutoff of ≥ 0.581. Ktrans and Ve did not show significant statistical difference.
Conclusion: RESOLVE DWI and DCE-MRI are effective non-invasive tools for differentiating benign and malignant skull base lesions. The ADC ratio and Kep are valuable quantitative markers, while TIC pattern analysis offers complementary qualitative insights, enhancing diagnostic confidence.
期刊介绍:
Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.