{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T03:43:26Z","timestamp":1779248606261,"version":"3.51.4"},"reference-count":43,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,3,4]],"date-time":"2022-03-04T00:00:00Z","timestamp":1646352000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Gda\u0144sk Medical University","award":["664\/323\/61\/71-1208"],"award-info":[{"award-number":["664\/323\/61\/71-1208"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biology"],"abstract":"<jats:p>Aim: The aim of this prospective study is to identify quantitative intravoxel incoherent motion and dynamic contrast-enhanced magnetic resonance imaging parameters of the most frequent benign parotid tumors, compare their utility and diagnostic accuracy. Methods: The study group consisted of 52 patients with 64 histopathologically confirmed parotid focal lesions. Parametric maps representing apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (FP) and transfer constant (Ktrans), reflux constant (Kep), extra-vascular extra-cellular volume fraction (Ve), and initial area under curve in 60 s (iAUC) have been obtained from multiparametric MRI. Results: Statistically significant (p &lt; 0.001) inter-group differences were found between pleomorphic adenomas (PA) and Warthin tumors (WT) in all tested parameters but iAUC. Receiver operating characteristic curves were constructed to determine the optimal cut-off levels of the most significant parameters allowing differentiation between WT and PA. The Area Under the Curve (AUC) values and thresholds were for ADC: 0.931 and 1.05, D: 0.896 and 0.9, Kep: 0.964 and 1.1 and Ve: 0.939 and 0.299, respectively. Lesions presenting with a combination of ADC, D, and Ve values superior to the cut-off and Kep values inferior to the cut-off are classified as pleomorphic adenomas. Lesions presenting with combination of ADC, D, and Ve values inferior to the cut-off and Kep values superior to the cut-off are classified as Warthin tumors. Conclusions: DWI, IVIM and quantitative analysis of DCE-MRI derived parameters demonstrated distinctive features of PAs and WT and as such they seem feasible in differentiation of benign parotid gland tumors.<\/jats:p>","DOI":"10.3390\/biology11030399","type":"journal-article","created":{"date-parts":[[2022,3,6]],"date-time":"2022-03-06T20:35:50Z","timestamp":1646598950000},"page":"399","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Feasibility of Intravoxel Incoherent Motion (IVIM) and Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) in Differentiation of Benign Parotid Gland Tumors"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1984-2959","authenticated-orcid":false,"given":"Karolina","family":"Markiet","sequence":"first","affiliation":[{"name":"2nd Department of Radiology, Medical University of Gdansk, 80-214 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4516-8881","authenticated-orcid":false,"given":"Anna","family":"Glinska","sequence":"additional","affiliation":[{"name":"2nd Department of Radiology, Medical University of Gdansk, 80-214 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6536-3094","authenticated-orcid":false,"given":"Tomasz","family":"Nowicki","sequence":"additional","affiliation":[{"name":"2nd Department of Radiology, Medical University of Gdansk, 80-214 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edyta","family":"Szurowska","sequence":"additional","affiliation":[{"name":"2nd Department of Radiology, Medical University of Gdansk, 80-214 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boguslaw","family":"Mikaszewski","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Medical University of Gdansk, 80-214 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,4]]},"reference":[{"key":"ref_1","unstructured":"Barnes, L., Eveson, J.W., Reichart, P., and Sidransky, D. (2005). World Health Organization Classification of Tumors\u2014Pathology and Genetics of Head and Neck Tumors, IARC Press."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1002\/lary.24964","article-title":"Etiology and management of recurrent parotid pleomorphic adenoma","volume":"125","author":"Witt","year":"2015","journal-title":"Laryngoscope"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1467","DOI":"10.1002\/lary.21830","article-title":"Variables related to recurrence of pleomorphic adenomas: Outcome of parotid surgery in 182 cases","volume":"121","author":"Riad","year":"2011","journal-title":"Laryngoscope"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Faquin, W.C., Rossi, E.D., Baloch, Z., Barkan, G.A., Foschini, M.P., Kurtycz, D.F.I., Pusztaszeri, M., and Vielh, P. (2018). The Milan System for Reporting Salivary Gland Cytopathology, Springer International Publishing AG.","DOI":"10.1007\/978-3-319-71285-7"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.diii.2020.08.002","article-title":"Multiparametric magnetic resonance imaging of parotid tumors: A systematic review","volume":"102","author":"Coudert","year":"2021","journal-title":"Diagn. Interv. Imaging"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.oraloncology.2017.03.016","article-title":"Intravoxel incoherent motion magnetic resonance imaging in head and neck cancer: A systematic review of the diagnostic and prognostic value","volume":"68","author":"Noij","year":"2017","journal-title":"Oral Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.clinimag.2018.05.026","article-title":"Diagnostic accuracy of magnetic resonance imaging techniques for parotid tumors, a systematic review and meta-analysis","volume":"52","author":"Liang","year":"2018","journal-title":"Clin. Imaging"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.oooo.2017.03.007","article-title":"Diffusion-weighted MRI in the differential diagnosis of parotid malignancies and pleomorphic adenomas: Can the accuracy of dynamic MRI be enhanced?","volume":"124","author":"Mikaszewski","year":"2017","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"104932","DOI":"10.1016\/j.oraloncology.2020.104932","article-title":"Clinical and demographic data improve diagnostic accuracy of dynamic contrast-enhanced and diffusion-weighted MRI in differential diagnostics of parotid gland tumors","volume":"111","author":"Mikaszewski","year":"2020","journal-title":"Oral Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1148\/radiology.168.2.3393671","article-title":"Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging","volume":"168","author":"Breton","year":"1988","journal-title":"Radiology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1002\/mrm.1910270116","article-title":"The capillary network: A link between IVIM and classical perfusion","volume":"27","author":"Turner","year":"1992","journal-title":"Magn. Reason. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.neuroimage.2017.12.062","article-title":"What can we see with IVIM MRI?","volume":"187","year":"2019","journal-title":"Neuroimage"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"5627","DOI":"10.1007\/s00330-019-06133-8","article-title":"Distinguishing early-stage nasopharyngeal carcinoma from benign hyperplasia using intravoxel incoherent motion diffusion-weighted MRI","volume":"29","author":"Ai","year":"2019","journal-title":"Eur. Radiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"875","DOI":"10.3390\/cancers5030875","article-title":"Utility of MRI diffusion techniques in the evaluation of tumors of the head and neck","volume":"5","year":"2013","journal-title":"Cancers"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1016\/j.mri.2014.08.009","article-title":"Intravoxel incoherent motion diffusion-weighted imaging in head and neck squamous cell carcinoma: Assessment of perfusion-related parameters compared to dynamic contrast-enhanced MRI","volume":"32","author":"Fujima","year":"2014","journal-title":"Magn. Reason. Imaging"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1806","DOI":"10.1002\/nbm.3020","article-title":"Assessment of diffusion parameters by intravoxel incoherent motion MRI in head and neck squamous cell carcinoma","volume":"26","author":"Marzi","year":"2013","journal-title":"NMR Biomed."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1007\/s00330-016-4440-1","article-title":"Prediction of the treatment outcome using intravoxel incoherent motion and diffusional kurtosis imaging in nasal or sinonasal squamous cell carcinoma patients","volume":"27","author":"Fujima","year":"2017","journal-title":"Eur. Radiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"243","DOI":"10.3348\/kjr.2020.0290","article-title":"Intravoxel Incoherent Motion Magnetic Resonance Imaging for Assessing Parotid Gland Tumors: Correlation and Comparison with Arterial Spin Labeling Imaging","volume":"22","author":"Ma","year":"2021","journal-title":"Korean J. Radiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1016\/j.ejrad.2014.02.013","article-title":"Prediction of treatment response in head and neck carcinomas using IVIM-DWI: Evaluation of lymph node metastasis","volume":"83","author":"Hauser","year":"2014","journal-title":"Eur. J. Radiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"506","DOI":"10.12659\/PJR.902275","article-title":"Application of Intravoxel Incoherent Motion (IVIM) Model for Differentiation Between Metastatic and Non-Metastatic Head and Neck Lymph Nodes","volume":"82","author":"Hejduk","year":"2017","journal-title":"Pol. J. Radiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.mri.2016.10.004","article-title":"Correlation study between intravoxel incoherent motion MRI and dynamic contrast-enhanced MRI in head and neck squamous cell carcinoma: Evaluation in primary tumors and metastatic nodes","volume":"37","author":"Marzi","year":"2017","journal-title":"Magn. Reason. Imaging"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.ejrad.2017.02.039","article-title":"Lymph node metastasis in head and neck squamous carcinoma: Efficacy of intravoxel incoherent motion magnetic resonance imaging for the differential diagnosis","volume":"90","author":"Liang","year":"2017","journal-title":"Eur. J. Radiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1002\/jmri.25523","article-title":"Intravoxel incoherent motion diffusion-weighted MRI during chemoradiation therapy to characterize and monitor treatment response in human papillomavirus head and neck squamous cell carcinoma","volume":"45","author":"Paudyal","year":"2017","journal-title":"J. Magn. Reason. Imaging"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1002\/nbm.3412","article-title":"Intravoxel incoherent motion imaging kinetics during chemoradiotherapy for human papillomavirus-associated squamous cell carcinoma of the oropharynx: Preliminary results from a prospective pilot study","volume":"28","author":"Ding","year":"2015","journal-title":"NMR Biomed."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1186\/s13014-018-1137-4","article-title":"Radiation-induced parotid changes in oropharyngeal cancer patients: The role of early functional imaging and patient-\/treatment-related factors","volume":"13","author":"Marzi","year":"2018","journal-title":"Radiat Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.ejrad.2016.11.021","article-title":"Correlation between intravoxel incoherent motion MR parameters and MR nodular grade of parotid glands in patients with Sj\u00f6gren\u2019s syndrome: A pilot study","volume":"86","author":"Chu","year":"2017","journal-title":"Eur. J. Radiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1002\/jmri.25096","article-title":"Feasibility study of using intravoxel incoherent motion mri to detect parotid gland abnormalities in early-stage Sj\u00f6gren syndrome patients","volume":"43","author":"Su","year":"2016","journal-title":"J. Magn. Reason. Imaging"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1148\/radiol.2262011486","article-title":"Salivary gland tumors: Diagnostic value of gadolinium-enhanced dynamic MR imaging with histopathologic correlation","volume":"226","author":"Yabuuchi","year":"2003","journal-title":"Radiology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"410","DOI":"10.3174\/ajnr.A3227","article-title":"Head and neck tumors: Assessment of perfusion-related parameters and diffusion coefficients based on the intravoxel incoherent motion model","volume":"34","author":"Sumi","year":"2013","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"6402","DOI":"10.1007\/s00330-020-07004-3","article-title":"Characterization of parotid gland tumors: Added value of permeability MR imaging to DWI and DCE-MRI","volume":"30","author":"Yabuuchi","year":"2020","journal-title":"Eur. Radiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"641","DOI":"10.3348\/kjr.2016.17.5.641","article-title":"Intravoxel Incoherent Motion MR Imaging in the Head and Neck: Correlation with Dynamic Contrast-Enhanced MR Imaging and Diffusion-Weighted Imaging","volume":"17","author":"Xu","year":"2016","journal-title":"Korean J. Radiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1007\/s00330-013-3002-z","article-title":"Head and neck tumours: Combined MRI assessment based on IVIM and TIC analyses for the differentiation of tumors of different histological types","volume":"24","author":"Sumi","year":"2014","journal-title":"Eur. Radiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2893","DOI":"10.2217\/fon-2017-0655","article-title":"A multiparametric analysis combining DCE-MRI- and IVIM -derived parameters to improve differentiation of parotid tumors: A pilot study","volume":"14","author":"Patella","year":"2018","journal-title":"Future Oncol."},{"key":"ref_34","unstructured":"ITIS Foundation (2021, November 01). Available online: https:\/\/itis.swiss\/virtual-population\/tissue-properties\/database\/relaxation-times\/."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1002\/mrm.21066","article-title":"Experimentally-derived functional form for a population-averaged high-temporal-resolution arterial input function for dynamic contrast-enhanced MRI","volume":"56","author":"Parker","year":"2006","journal-title":"Magn. Reason. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.jcm.2016.02.012","article-title":"A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research","volume":"15","author":"Koo","year":"2017","journal-title":"J. Chiropr. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.mric.2021.07.006","article-title":"MR Imaging of Salivary Gland Tumors","volume":"30","author":"Friedman","year":"2022","journal-title":"Magn. Reson. Imaging Clin. N. Am."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"29","DOI":"10.5603\/FM.a2017.0115","article-title":"An algorithm for preoperative differential diagnostics of parotid tumours on the basis of their dynamic and diffusion-weighted magnetic resonance images: A retrospective analysis of 158 cases","volume":"77","author":"Mikaszewski","year":"2018","journal-title":"Folia Morphol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"110094","DOI":"10.1016\/j.ejrad.2021.110094","article-title":"Differential diagnosis of parotid gland tumours: Application of SWI combined with DWI and DCE-MRI","volume":"146","author":"Xu","year":"2022","journal-title":"Eur. J. Radiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.clinimag.2017.06.009","article-title":"Differentiating parotid tumors by quantitative signal intensity evaluation on MR imaging","volume":"46","author":"Matsusue","year":"2017","journal-title":"Clin. Imaging"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/j.carj.2018.10.010","article-title":"Diagnostic Accuracy of Multiparametric Magnetic Resonance Imaging for Differentiation Between Parotid Neoplasms","volume":"70","author":"Elmokadem","year":"2019","journal-title":"Can. Assoc. Radiol. J."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"125","DOI":"10.5152\/etd.2017.17033","article-title":"Diffusion-weighted imaging of the parotid gland: Can the apparent diffusion coefficient discrim- inate between normal and abnormal parotid gland tissues?","volume":"39","author":"Nada","year":"2017","journal-title":"Erciyes Med. J."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1148\/radiol.12111248","article-title":"Salivary gland tumors: Use of intravoxel incoherent motion MR imaging for assessment of diffusion and perfusion for the differentiation of benign from malignant tumors","volume":"263","author":"Sumi","year":"2012","journal-title":"Radiology"}],"container-title":["Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-7737\/11\/3\/399\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:32:01Z","timestamp":1760135521000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-7737\/11\/3\/399"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,4]]},"references-count":43,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["biology11030399"],"URL":"https:\/\/doi.org\/10.3390\/biology11030399","relation":{},"ISSN":["2079-7737"],"issn-type":[{"value":"2079-7737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,4]]}}}