René-Charles Rouchy1,2, Arnaud Attyé3,4, Maud Medici5,6, Félix Renard4, Adrian Kastler3,4, Sylvie Grand3,4, Irène Tropres4,7, Christian Adrien Righini8, Alexandre Krainik3,4. 1. Department of Neuroradiology and MRI, Grenoble Alpes University Hospital - SFR RMN Neurosciences, F-38043, Grenoble, Cedex 9, France. rcrouchy1@chu-grenoble.fr. 2. University of Grenoble Alpes, IRMaGe, F-38000, Grenoble, France. rcrouchy1@chu-grenoble.fr. 3. Department of Neuroradiology and MRI, Grenoble Alpes University Hospital - SFR RMN Neurosciences, F-38043, Grenoble, Cedex 9, France. 4. University of Grenoble Alpes, IRMaGe, F-38000, Grenoble, France. 5. Clinical Investigation Centre 1406 - Innovative Technology, National Institute of Health and Medical Research, Grenoble, France. 6. Public Health Department, Grenoble Alpes University Hospital, Grenoble, France. 7. IRMaGe, Inserm US 17, CNRS UMS 3552, Grenoble, France. 8. Department of Otololaryngology, Grenoble Alpes University Hospital, Grenoble, France.
Abstract
OBJECTIVES: To determine whether facial nerve MR tractography is useful in detecting PeriNeural Spread in parotid cancers. METHODS: Forty-five participants were enrolled. Thirty patients with surgically managed parotid tumors (15 malignant, 15 benign) were compared with 15 healthy volunteers. All of them had undergone 3T-MRI with diffusion acquisition and post-processing constrained spherical deconvolution-based tractography. Parameters of diffusion-weighted sequences were b-value 1,000 s/mm2, 32 directions. Two radiologists performed a blinded visual reading of tractographic maps and graded the facial nerve average pathlength and fractional anisotropy (FA). We also compared diagnostic accuracy of tractography with morphological MRI sequences to detect PeriNeural Spread. Non-parametric methods were used. RESULTS: Average pathlength was significantly higher in cases with PeriNeural Spread (39.86 mm [Quartile1: 36.27; Quartile3: 51.19]) versus cases without (16.23 mm [12.90; 24.90]), p<0.001. The threshold above which there was a significant association with PeriNeural Spread was set at 27.36 mm (Se: 100%; Sp: 84%; AUC: 0.96, 95% CI 0.904-1). There were no significant differences in FA between groups. Tractography map visual analyses directly displayed PeriNeural Spread in distal neural ramifications with sensitivity of 75%, versus 50% using morphological sequences. CONCLUSIONS: Tractography could be used to identify facial nerve PeriNeural Spread by parotid cancers. KEY POINTS: • Tractography could detect facial nerve PeriNeural Spread in parotid cancers. • The average pathlength parameter is increased in case of PeriNeural Spread. • Tractography could map PeriNeural Spread more precisely than conventional imaging.
OBJECTIVES: To determine whether facial nerve MR tractography is useful in detecting PeriNeural Spread in parotid cancers. METHODS: Forty-five participants were enrolled. Thirty patients with surgically managed parotid tumors (15 malignant, 15 benign) were compared with 15 healthy volunteers. All of them had undergone 3T-MRI with diffusion acquisition and post-processing constrained spherical deconvolution-based tractography. Parameters of diffusion-weighted sequences were b-value 1,000 s/mm2, 32 directions. Two radiologists performed a blinded visual reading of tractographic maps and graded the facial nerve average pathlength and fractional anisotropy (FA). We also compared diagnostic accuracy of tractography with morphological MRI sequences to detect PeriNeural Spread. Non-parametric methods were used. RESULTS: Average pathlength was significantly higher in cases with PeriNeural Spread (39.86 mm [Quartile1: 36.27; Quartile3: 51.19]) versus cases without (16.23 mm [12.90; 24.90]), p<0.001. The threshold above which there was a significant association with PeriNeural Spread was set at 27.36 mm (Se: 100%; Sp: 84%; AUC: 0.96, 95% CI 0.904-1). There were no significant differences in FA between groups. Tractography map visual analyses directly displayed PeriNeural Spread in distal neural ramifications with sensitivity of 75%, versus 50% using morphological sequences. CONCLUSIONS: Tractography could be used to identify facial nerve PeriNeural Spread by parotid cancers. KEY POINTS: • Tractography could detect facial nerve PeriNeural Spread in parotid cancers. • The average pathlength parameter is increased in case of PeriNeural Spread. • Tractography could map PeriNeural Spread more precisely than conventional imaging.
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