Diffusion weighted imaging of esthesioneuroblastoma: Differentiation from other sinonasal masses.

Abstract

Differentiating esthesioneuroblastoma (ENB) from other sinonasal tumors is difficult by MRI. We tested whether diffusion weighted imaging (DWI) could distinguish ENB from other sinonasal tumors. Hundred forty-six patients underwent sinonasal MRI, 75 with technically successful DWI. Pathology: 18 ENB (24%), 34 (45%) other malignant tumors, and 23 (31%) benign lesions. Apparent diffusion coefficients (ADCs) were calculated. Average ADC and normalized ADC of ENB (1.22 × 10^-3 ± 0.28 mm² /s and 1.55 ± 0.36, respectively) were higher than other malignancies (0.98 × 10^-3 ± 0.18 mm² /s and 1.31 ± 0.29, P = .002 and P = .034) and lower than benign disease (1.92 × 10^-3 ± 0.33 mm² /s and 2.44 ± 0.50, P < .0001). ADC differentiated ENB from benign disease with 91% sensitivity and 83% specificity. An ADC cutoff of 1.1 × 10^-3 mm² /s differentiated other malignancies from ENB with 72% sensitivity and 85% specificity. DWI is useful in distinguishing ENB from other sinonasal disease.