{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T12:34:21Z","timestamp":1763037261175},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,11,26]],"date-time":"2018-11-26T00:00:00Z","timestamp":1543190400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Differential diagnosis of the mucosa\u2010associated lymphoid tissue lymphoma (MALToma) and tumor\u2010like benign lymphoepithelial lesion (BLEL) in the parotid gland is difficult.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To distinguish MALToma and BLEL with multimodality MRI including hydrogenproton magnetic resonance spectroscopy (<jats:sup>1<\/jats:sup>H\u2010MRS), diffusion\u2010weighted imaging (DWI\u2010MR), and dynamic contrast\u2010enhanced (DCE\u2010MR), and evaluate each sequence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Retrospective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Twenty\u2010five patients with parotid tumor\u2010like BLEL and 20 with parotid MALToma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>1.5\u2010T\/T<jats:sub>1<\/jats:sub>WI, T<jats:sub>2<\/jats:sub>WI, single\u2010voxel <jats:sup>1<\/jats:sup>H\u2010MRS, DWI\u2010MR, and DCE\u2010MR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>All MR images were interpreted and agreed upon by two radiologists who were blinded to clinical information and histopathologic results. The imaging diagnoses were then compared to the histopathologic results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Youden index was used to determine the optimized threshold value. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficiency of different functional (f)MRI methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fisher's exact test indicated a significant difference between the <jats:sup>1<\/jats:sup>H\u2010MRS images of the two lesions (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). The sensitivity, specificity, and accuracy of positive choline (Cho) peak in <jats:sup>1<\/jats:sup>H\u2010MRS of parotid MALToma were 80%, 76%, and 77.7%, respectively. The mean apparent diffusion coefficient (ADC) was 0.992 \u00d7 10<jats:sup>\u22123<\/jats:sup>mm<jats:sup>2<\/jats:sup>\/s in patients with parotid tumor\u2010like BLEL and 0.634 \u00d7 10<jats:sup>\u22123<\/jats:sup>mm<jats:sup>2<\/jats:sup>\/s in patients with parotid MALToma, and the difference was statistically significant (<jats:italic>t<\/jats:italic>\u2010test, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Choosing the Youden index as 0.669 \u00d7 10<jats:sup>\u22123<\/jats:sup>mm<jats:sup>2<\/jats:sup>\/s, the sensitivity, specificity, and accuracy of the assay were 78.9%, 95.8%, and 88.4%, respectively. Assuming that time\u2010intensity curve (TIC) type I indicated parotid MALToma (positive), and type II and type III indicated parotid tumor\u2010like BLEL (negative), the sensitivity, specificity, and accuracy of time\u2010to\u2010peak (TTP) and initial slope of increase (ISI) in diagnosing MALToma were 94.1%, 95.2%, and 94.7%, respectively. Combining methods of TTP, ADC, and Cho peak reached the highest AUC (1.000).<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>Combined use <jats:sup>1<\/jats:sup>H\u2010MRS, DWI\u2010MR, and DCE\u2010MR increased the accuracy of the differential diagnosis between these lesions to 100%. Cho peak in <jats:sup>1<\/jats:sup>H\u2010MRS, ADC less than 0.669 \u00d7 10<jats:sup>\u22123<\/jats:sup>mm<jats:sup>2<\/jats:sup>\/s, TIC type I together indicated parotid MALToma.<\/jats:p><jats:p><jats:bold>Level of Evidence:<\/jats:bold> 3<\/jats:p><jats:p><jats:bold>Technical Efficacy:<\/jats:bold> Stage 2<\/jats:p><jats:p>J. Magn. Reson. Imaging 2019;49:423\u2013432.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.26260","type":"journal-article","created":{"date-parts":[[2018,11,26]],"date-time":"2018-11-26T15:05:42Z","timestamp":1543244742000},"page":"423-432","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Multimodality fMRI with perfusion, diffusion\u2010weighted MRI and <sup>1<\/sup>H\u2010MRS in the diagnosis of lympho\u2010associated benign and malignant lesions of the parotid gland"],"prefix":"10.1002","volume":"49","author":[{"given":"Ling","family":"Zhu","sequence":"first","affiliation":[{"name":"Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine Department of Radiology  Shanghai P.R. 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