Effective combination of 3 imaging modalities in differentiating malignant and benign palatal lesions

Abstract Objective To evaluate whether computed tomography (CT), magnetic resonance imaging (MRI), and positron-emission tomography/computed tomography (PET/CT) can effectively differentiate between malignant and benign palatal lesions. Study Design In total, 59 patients with palatal lesions (32 malignant and 27 benign), who underwent CT, MRI, and/or PET/CT imaging examinations and had histopathological diagnoses, were divided into an analysis (n = 46) and a validation group (n = 13). Bone changes adjacent to the lesion, MRI signal intensity, apparent diffusion coefficient (ADC), time of peak enhancement (Tpeak), and maximum standardized uptake values (SUVmax) were evaluated in the analysis group. Diagnostic performance was individually assessed for each parameter for differentiating between malignant and benign lesions. A diagnostic decision tree was constructed using useful parameters and its accuracy tested in the validation group. Results The frequency distribution of bone change types and Tpeak differed significantly between malignant and benign lesions. The ADC of malignant lymphoma was significantly lower than that of other lesions. The other parameters did not distinguish lesion types. The accuracy of the decision tree, constructed using bone change types, ADC, and Tpeak, was 87.5%. Conclusion ADC values, bone change types, and Tpeak are useful for differentiating between malignant and benign palatal lesions.