Texture analysis of T2-weighted MRI predicts SDH mutation in paraganglioma
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HEAD-NECK-ENT RADIOLOGY
Texture analysis of T2-weighted MRI predicts SDH mutation in paraganglioma Shotaro Naganawa 1
&
John Kim 1 & Stephen S. F. Yip 2,3 & Yoshiaki Ota 1 & Ashok Srinivasan 1 & Toshio Moritani 1
Received: 17 September 2020 / Accepted: 12 November 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Texture analysis can quantify sophisticated imaging characteristics. We hypothesized that 2D textures computed with T2-weighted and post-contrast T1-weighted MRI can predict succinate dehydrogenase (SDH) mutation status in head and neck paragangliomas. Methods Our retrospective study included 21 patients (1 to 4 tumors/patient) with 24 pathologically proven paragangliomas in the head and neck. Fourteen lesions (58%) were SDH mutation-positive. All patients underwent T2-weighted and post-contrast T1-weighted MRI sequences. Three 2D texture features of dependence non-uniformity normalized (DNN), small dependence high gray level emphasis (SDHGLE), and small dependence low gray level emphasis (SDLGLE) were calculated. Computed textures between SDH mutants and non-mutants were compared using Mann-Whitney U test. Area under the receiver operating characteristic (AUROC) curve was used to quantify the predictive power of each texture. Results Only T2-based SDLGLE was statistically significant (p = 0.048), and AUROC was 0.71. Diagnostic accuracy was 70.8%. Conclusion 2D texture parameter of T2-based SDLGLE predicts SDH mutation in head and neck paragangliomas. This noninvasive technique can potentially facilitate further genetic workup. Keywords Texture analysis . SDH . Paraganglioma
Introduction Head and neck paragangliomas (HN-PGLs) are rare, usually benign tumors of the sympathoadrenal neuroendocrine system, and 35% of HN-PGLs are estimated to have genetic predisposition. Succinate dehydrogenase (SDH) gene mutation is a known cause of familial paraganglioma and pheochromocytoma, thyroid and ovarian cancers [1]. Detecting SDH mutation is clinically important as the carriers are associated with a high risk of malignancy and recurrence [2]. Genetic testing for germline mutation in HN-PGL patients is * Shotaro Naganawa [email protected] 1
Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., UH B2A209K, Ann Arbor, MI 48109, USA
2
Department of Medical Physics, University of Wisconsin - Madison, 1111 Highland Ave, Rm 1005, Madison, WI 53705-2275, USA
3
AIQ Solutions, Inc, 1111 Deming Way, Madison, WI 53717, USA
used for diagnosis, treatment guidance, and disease surveillance. While observation without treatment is an appropriate option for asymptomatic patients, the standard treatment for malignant paragangliomas is surgical resection [3]. Surgical resection is recommended in patients positive for SDH mutation due to the high inherent risk of the tumor being malignant [4]. HN-PGLs have characteristic imaging features of multiple areas of signal void interspersed with hyperintense foci (saltand-pepper appearance) on T
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