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

Background: 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.

Methods: 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.

Results: Average ADC and normalized ADC of ENB (1.22 × 10 ± 0.28 mm /s and 1.55 ± 0.36, respectively) were higher than other malignancies (0.98 × 10 ± 0.18 mm /s and 1.31 ± 0.29, P = .002 and P = .034) and lower than benign disease (1.92 × 10 ± 0.33 mm /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 mm /s differentiated other malignancies from ENB with 72% sensitivity and 85% specificity.

Conclusions: DWI is useful in distinguishing ENB from other sinonasal disease.