Saini M, Manchanda S, Bhalla AS, Kandasamy D, Kakkar A, Thakar A. Multiparametric magnetic resonance imaging in differentiating benign and malignant sinonasal masses: A prospective study and literature review. World J Methodol 2026; 16(1): 107426 [DOI: 10.5662/wjm.v16.i1.107426]
Corresponding Author of This Article
Smita Manchanda, MD, Professor, Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. smitamanchanda@gmail.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Observational Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Mar 20, 2026 (publication date) through Feb 10, 2026
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Journal Information of This Article
Publication Name
World Journal of Methodology
ISSN
2222-0682
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Saini M, Manchanda S, Bhalla AS, Kandasamy D, Kakkar A, Thakar A. Multiparametric magnetic resonance imaging in differentiating benign and malignant sinonasal masses: A prospective study and literature review. World J Methodol 2026; 16(1): 107426 [DOI: 10.5662/wjm.v16.i1.107426]
Manish Saini, Smita Manchanda, Ashu S Bhalla, Devasenathipathy Kandasamy, Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi 110029, India
Aanchal Kakkar, Department of Pathology, All India Institute of Medical Sciences, New Delhi 110029, India
Alok Thakar, Department of Otorhinolaryngology and Skull Base Surgery, All India Institute of Medical Sciences, New Delhi 110029, India
Author contributions: Saini M designed the research study; was involved in the data acquisition, collection, and analysis; and wrote the first draft of the manuscript; Manchanda S designed the research study, collected the data, and wrote and edited the manuscript; Bhalla AS and Kandasamy D designed the research study and reviewed and edited the manuscript; Kakkar A and Thakar A reviewed and edited the manuscript; All authors have read and approved the final manuscript.
Institutional review board statement: All procedures performed in the study were in accordance with the ethical standards of the institute and were preapproved by the Institute Review Board (No. IECPG-487/25.08.2021).
Informed consent statement: Informed consent was obtained from all individual participants included in the study.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement- checklist of items.
Data sharing statement: All data and materials are available from the corresponding author, upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Smita Manchanda, MD, Professor, Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. smitamanchanda@gmail.com
Received: March 24, 2025 Revised: April 28, 2025 Accepted: June 19, 2025 Published online: March 20, 2026 Processing time: 324 Days and 15.9 Hours
Abstract
BACKGROUND
The sinonasal area poses diagnostic challenges due to a range of benign and malignant tumors presenting with vague symptoms. Conventional magnetic resonance imaging (MRI) has limited specificity in differentiation.
AIM
To study the role of dynamic contrast-enhanced MRI (DCE-MRI), intravoxel incoherent motion imaging (IVIM), diffusion kurtosis imaging (DKI), and conventional diffusion-weighted imaging (DWI) for distinguishing between benign and malignant sinonasal masses.
METHODS
This prospective study was conducted at a tertiary center in which 30 patients with sinonasal masses (18 malignant lesions and 12 benign lesions) underwent routine MRI, conventional DWI and IVIM, and DCE-MRI. Various imaging parameters were measured and compared between two groups.
RESULTS
Malignant lesions exhibited significantly lower apparent diffusion coefficient (ADC), true diffusion coefficient (Dt), and apparent diffusion coefficient (Dapp) values (P = 0.000, P = 0.015, and P = 0.030, respectively) and higher apparent kurtosis coefficient (Kapp) values (P = 0.001) than benign lesions. There were no significant differences in the pseudodiffusion coefficient, perfusion fraction, or perfusion parameters. Among all of the significant parameters, the ADC had the highest area under the curve (0.898). An ADC cutoff value of 1.57 × 10-3 mm2/second had a sensitivity of 88.89% and specificity of 83.33% to predict a malignant lesion. Our conventional DWI findings are in accordance with the published literature.
CONCLUSION
This study highlights the utility of conventional DWI, DKI, and IVIM as noninvasive methods for distinguishing between benign and malignant sinonasal lesions; however, there is no added advantage of DKI and IVIM over conventional DWI. Similarly, the perfusion parameters also did not show an additive role in distinguishing between benign and malignant sinonasal lesions.
Core Tip: We studied the role of advanced magnetic resonance imaging techniques in the evaluation of sinonasal masses. The mean apparent diffusion coefficient derived from conventional diffusion-weighted imaging (DWI) can serve as an imaging marker to differentiate between benign and malignant sinonasal masses. Other imaging parameters such as the true diffusion coefficient from intravoxel incoherent motion imaging (IVIM), kurtosis coefficient, and diffusion coefficient from diffusion kurtosis imaging (DKI) were also statistically significant. However, there was no incremental benefit of DKI and IVIM over conventional DWI. Perfusion parameters also did not show any significant difference.
