Amide proton transfer imaging and diffusion kurtosis imaging for the differentiation of salivary gland tumors.

OBJECTIVE: To investigate the diagnostic value of amide proton transfer (APT) with diffusion kurtosis imaging (DKI) in differentiating among pleomorphic adenomas (PAs), Warthin tumors (WTs), and malignant tumors (MTs) of the salivary glands. STUDY DESIGN: This retrospective study enrolled 76 patients with pathologically confirmed salivary gland tumors (31 PAs, 29 WTs, and 16 MTs). All patients underwent MRI examinations that included DKI and APT sequences. The mean APT signal intensity (SI), mean diffusion coefficient (MD), and mean kurtosis (MK) were compared across the 3 groups. The discriminatory performance of combined APT and DKI parameters was evaluated using receiver operating characteristic (ROC) curve analysis. RESULTS: Compared with WT and MT, PA exhibited the lowest MK value (0.49 ± 0.16) and the highest MD value (1.91 ± 0.40 × 10⁻3 mm2/s). Compared with WT, PA demonstrated a higher mean APT SI value (2.55 ± 0.83) %. Furthermore, compared with MT, WT exhibited a lower mean APT SI (1.83 ± 0.55) % and a higher MK value (1.01 ± 0.28) (all P < .05). Logistic regression models combining multiple parameters yielded AUC values ranging from 0.730 to 0.952 for differentiation. CONCLUSIONS: APT and DKI parameters provide valuable and complementary information for discriminating salivary gland tumor subtypes.