Differentiating between benign and malignant sinonasal lesions using dynamic contrast-enhanced MRI and intravoxel incoherent motion

Abstract Purpose To explore the value of dynamic contrast-enhanced MRI (DCE-MRI) and intravoxel incoherent motion (IVIM) for distinguishing between benign and malignant sinonasal lesions and investigate the correlations between the two methods. Methods and materials Patients with sinonasal lesions (42 benign and 31 malignant) who underwent DCE-MRI and IVIM before confirmation by histopathology were enrolled in this prospective study. Parameters derived from DCE-MRI and IVIM were measured, the optimal cut-off values for differential diagnosis were determined, and the correlations between the two methods were evaluated. Statistical analyses were performed using the Wilcoxon rank sum test, receiver operating characteristic (ROC) curve analysis, and Spearman’s rank correlation. Results Significantly higher K trans and K ep values but lower D and f values were found in malignant lesions than in benign lesions (all p   0.001). There were no significant differences in the V e and D* values between the two groups. The area under the curve (AUC) of K trans was significantly higher than those of other parameters. There was no significant difference between the AUCs of DCE-MRI and IVIM with parameters combined ( p  = 0.86). Significant inverse but weak correlations were found between D and K trans (r = −0.46, p trans (r = −0.41, p ep (r = −0.37, p  = 0.008), and f and K ep (r = −0.33, p  = 0.004). Conclusions DCE-MRI and IVIM can effectively differentiate between benign and malignant sinonasal lesions. IVIM findings correlate with DCE-MRI results and may represent an alternative to DCE-MRI.