{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T06:19:18Z","timestamp":1775542758976,"version":"3.50.1"},"reference-count":18,"publisher":"Korean Rhinologic Society","issue":"1","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["j-rhinology.org"],"crossmark-restriction":true},"short-container-title":["J Rhinol"],"published-print":{"date-parts":[[2026,3,31]]},"abstract":"<jats:p>Background and Objectives: Differentiating inverted papilloma (IP) from squamous cell carcinoma arising in IP (IP+SCC) is challenging when computed tomography (CT) demonstrates no bone destruction. This study aimed to identify CT and magnetic resonance imaging (MRI) features that distinguish IP from IP+SCC in cases without bone destruction on CT.Methods: We retrospectively reviewed 30 patients with histologically confirmed sinonasal IP (n=15) or IP+SCC (n=15) who underwent preoperative CT and MRI between 2010 and 2023. Imaging variables assessed included tumor origin, tumor volume, CT enhancement pattern, signal intensity on T2-weighted and contrast-enhanced T1-weighted images, apparent diffusion coefficient (ADC), and the presence or loss of the convoluted cerebriform pattern (CCP). Group differences were analyzed using appropriate statistical tests, with p&lt;0.05 considered statistically significant.Results: There was no statistically significant difference in tumor origin between the IP and IP+SCC groups. Tumor volume and CT enhancement patterns also did not differ significantly between the groups. On MRI, IP+SCC more frequently demonstrated intermediate signal intensity on both T2-weighted and contrast-enhanced T1-weighted images compared with IP (p=0.025 and p=0.029, respectively). Median ADC values were significantly lower in the IP+SCC group than in the IP group (0.99\u00d710&lt;sup&gt;-3&lt;\/sup&gt; vs. 1.20\u00d710&lt;sup&gt;-3&lt;\/sup&gt; mm&lt;sup&gt;2&lt;\/sup&gt;\/s; p=0.026). Loss of the CCP was more common in the IP+SCC group, although the difference did not reach statistical significance.Conclusion: In sinonasal IP without bone destruction on CT, MRI appears to be more informative than CT for distinguishing IP+SCC from IP. Intermediate signal intensity on T2-weighted and contrast-enhanced T1-weighted images, along with lower ADC values, supports malignant transformation, whereas tumor size, CT enhancement, and CCP alone are less reliable discriminators.<\/jats:p>","DOI":"10.18787\/jr.2025.00062","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T06:35:56Z","timestamp":1774938956000},"page":"37-44","update-policy":"https:\/\/doi.org\/10.18787\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Radiologic Features for Differentiating Sinonasal Inverted Papilloma and Squamous Cell Carcinoma Arising From Inverted Papilloma Without Bone 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