Role of Multiparametric MRI in Parotid Gland Tumors: The Largest Case Series from Western India

Abstract

This study aimed to evaluate the potential and diagnostic accuracy of combining conventional and functional magnetic resonance imaging (MRI) parameters in the preoperative differential diagnosis of parotid gland tumors (PTs).

This prospective study was conducted in the department of radiology at a tertiary care center. Demographic details of the patients such as age, sex, weight, comorbidities, and body mass index were recorded. Comprehensive MR image analysis included tumor size, margins, signal intensity characteristics on T1-weighted image and T2-weighted image, apparent diffusion coefficient (ADC) values, and contrast enhancement patterns. After data filtration, the dataset was analyzed using MedCalc (version 20.0) and SPSS (version 22.0), with statistical significance set at p ≤ 0.05.

The study analyzed 75 PTs in 73 patients, identifying a malignancy rate of 40%, with benign tumors comprising 60%. MRI findings strongly correlated with malignancy, including irregular shape (76.7%), heterogeneous texture (64.3%), infiltrative margins (100%), hypointense signal (71%), low ADC values (≤1.2, 58.3%), and Type C time–intensity curve (TIC) patterns (90.9%). Combined MRI characteristics enhanced diagnostic accuracy, with optimal malignancy cutoff scores for various MRI techniques. Adding diffusion-weighted imaging to conventional MRI improved sensitivity (70.0%) and specificity (97.8%), while incorporating dynamic contrast-enhanced-MRI further enhanced diagnostic performance, achieving sensitivity of 66.7% and specificity of 100%.

Multiparametric MRI, integrating morphological features such as shape, signal intensity, and margins with functional metrics such as ADC values and TIC patterns provides a reliable, noninvasive method to differentiate benign from malignant PTs. This comprehensive approach enhances diagnostic accuracy and clinical confidence, addressing the limitations of standalone MRI techniques.