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. 2025 Aug 30;25(1):359.
doi: 10.1186/s12880-025-01898-5.

Diagnostic values of diffusion-weighted imaging and dynamic contrast-enhanced MRI in the pathological grading of adenoid cystic carcinoma

Peng An  1 , Nan Jiang  2 , Jinyan Li  1 , Wei Li  2 , Kun Zhou  3 , Jiaxiang Xin  4 , Peihang Jing  5 , Lixin Sun  6
Affiliations

Diagnostic values of diffusion-weighted imaging and dynamic contrast-enhanced MRI in the pathological grading of adenoid cystic carcinoma

Peng An et al. BMC Med Imaging. .

Abstract
in English, Spanish

Objectives: The combination of dynamic-contrast-enhanced-magnetic-resonance-imaging (DCE-MRI) with the apparent-diffusion-coefficient (ADC) holds significant value for predicting tumor pathological outcomes. This study pioneers the combined application of DCE-MRI and ADC parameters to evaluate their utility in differentiating histopathological grades of adenoid cystic carcinoma (ACC).

Methods: Retrospective diagnosis of 23 ear and temporal ACC patients was confirmed based on surgical pathology from March 2020 to April 2024. All patients underwent routine MRI, DWI, and DCE-MRI scans within one week before surgery. The lesion ADC values and DCE-MRI perfusion parameters, including Ve, Kep, Ktrans, and iAUC, were measured. Consistency tests were conducted on the measurements done by two physicians. The ADC values and DCE-MRI perfusion parameters between different pathological grades were compared. The correlation among all parameters and ACC pathological grading were analyzed, and the diagnostic accuracy of each parameter was assessed using receiver-operating-characteristic (ROC) curves.

Results: The measurements from the two observers showed high consistency (ICC > 0.9). Ktrans, iAUC, and ADC values demonstrated significant differences between different pathological grades (P < .01, P < .05, P < .05). Correlation analysis indicated that Ktrans, Kep, Ve, and iAUC were positively correlated with ACC pathological grading, and Ktrans demonstrated the most robust correlation (correlation coefficient r = .578, P < .01). In contrast, ADC values were markedly and negatively correlated with pathological grading (r=-.470, P < .05). In ROC analysis, the area-under-the-curve (AUC) for Ktrans, iAUC, and ADC were 0.841, 0.790, and 0.778, respectively, all higher than those for Kep and Ve. Ktrans showed the best diagnostic performance.

Conclusion: Combining DCE-MRI perfusion parameters with ADC values provides a non-invasive and effective method for preoperative grading of ACC, with Ktrans, iAUC, and ADC showing strong diagnostic potential. These findings support more accurate tumor characterization and personalized treatment planning, warranting further validation in larger prospective studies.

Clinical trial number: Not applicable.

• DWI and DCE-MRI can be used as non-invasive methods for preoperative assessment of the pathological grading of adenoid cystic carcinoma (ACC). • DCE-MRI perfusion parameters, including Ktrans, iAUC, and ADC values, have high diagnostic performance in the pathological grading of ACC.

Keywords: Adenoid cystic carcinoma; Fine-needle aspiration; Magnetic resonance imaging; Pathological grading; Perfusion parameters.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of Shandong Second Provincial General Hospital (Approval No. 2024-041-01). Written informed consent was obtained from all participants. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Violin plots displaying the differences in Ktrans, Kep, Ve, iAUC, and ADC between LG and HG groups (LG: Low-grade and HG: High-grade). Each plot shows the distribution of values, with width indicating the density of data at different values. Significant differences are shown by p-values
Fig. 2
Fig. 2
ROC curves illustrating the AUC values for each parameter: Ktrans, iAUC, Ve, Kep, and ADC. The AUC value for Ktrans was the largest, implying that Ktrans had the best diagnostic performance
See this image and copyright information in PMC

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