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09.04.2018 | Head and Neck

Facial nerve tractography: A new tool for the detection of perineural spread in parotid cancers

verfasst von: René-Charles Rouchy, Arnaud Attyé, Maud Medici, Félix Renard, Adrian Kastler, Sylvie Grand, Irène Tropres, Christian Adrien Righini, Alexandre Krainik

Erschienen in: European Radiology | Ausgabe 9/2018

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Abstract

Objectives

To determine whether facial nerve MR tractography is useful in detecting PeriNeural Spread in parotid cancers.

Methods

Forty-five participants were enrolled. Thirty patients with surgically managed parotid tumors (15 malignant, 15 benign) were compared with 15 healthy volunteers. All of them had undergone 3T-MRI with diffusion acquisition and post-processing constrained spherical deconvolution-based tractography. Parameters of diffusion-weighted sequences were b-value 1,000 s/mm², 32 directions. Two radiologists performed a blinded visual reading of tractographic maps and graded the facial nerve average pathlength and fractional anisotropy (FA). We also compared diagnostic accuracy of tractography with morphological MRI sequences to detect PeriNeural Spread. Non-parametric methods were used.

Results

Average pathlength was significantly higher in cases with PeriNeural Spread (39.86 mm [Quartile1: 36.27; Quartile3: 51.19]) versus cases without (16.23 mm [12.90; 24.90]), p<0.001. The threshold above which there was a significant association with PeriNeural Spread was set at 27.36 mm (Se: 100%; Sp: 84%; AUC: 0.96, 95% CI 0.904–1). There were no significant differences in FA between groups. Tractography map visual analyses directly displayed PeriNeural Spread in distal neural ramifications with sensitivity of 75%, versus 50% using morphological sequences.

Conclusions

Tractography could be used to identify facial nerve PeriNeural Spread by parotid cancers.

Key Points

• Tractography could detect facial nerve PeriNeural Spread in parotid cancers.

• The average pathlength parameter is increased in case of PeriNeural Spread.

• Tractography could map PeriNeural Spread more precisely than conventional imaging.

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Titel: Facial nerve tractography: A new tool for the detection of perineural spread in parotid cancers
verfasst von: René-Charles Rouchy
Arnaud Attyé
Maud Medici
Félix Renard
Adrian Kastler
Sylvie Grand
Irène Tropres
Christian Adrien Righini
Alexandre Krainik
Publikationsdatum: 09.04.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 9/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-018-5318-1

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Facial nerve tractography: A new tool for the detection of perineural spread in parotid cancers