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

Objective: The aim of this study was 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.

Methods: 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 group (n = 46) and a validation group (n = 13). Bone changes adjacent to the lesion, MRI signal intensity, apparent diffusion coefficient (ADC), time to 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 by 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 between lesion types. The accuracy of the decision tree, constructed by using bone change types, ADC, and Tpeak, was 87.5%.

Conclusions: Bone change types, ADC values, and Tpeak are useful for differentiating between malignant and benign palatal lesions.