Assessing Olfactory Bulb Infiltration and Morphological Changes in Olfactory Neuroblastoma Using MRI

Objectives: This study aimed to evaluate MRI-based changes in olfactory bulb (OB) volume and area to predict the likelihood of OB invasion in olfactory neuroblastoma (ONB). Design: Retrospective review of MRI data. Setting: Conducted at Jikei University, Japan, and the University of North Carolina, USA. Participants: The study included 46 ONB-diagnosed patients undergoing MRI and surgical treatment. Main Outcome Measures: Preoperative volume and cross-sectional area of the OB were measured, and the surgical pathology of the OB was reviewed. Results: Significant differences in OB metrics were observed between patients with and without olfactory bulb/tract invasions. ROC analysis demonstrated high discriminative ability: OB volume (AUC=0.971, cutoff 60 mm³) and maximum cross-sectional area (AUC=0.941, cutoff 9.5 mm²) both showed high sensitivity and specificity for predicting OB invasion. The left-right OB difference, with a lesion/non-lesion ratio exceeding 175%, was a strong predictor. Conclusions: Quantitative MRI metrics of the OB are effective in predicting invasion in ONB. These findings may enhance diagnostic accuracy and influence treatment strategies. Further research is warranted to validate these findings in larger cohorts.

Publication History

Received: 18 February 2025

Accepted after revision: 12 May 2025

Accepted Manuscript online:
14 May 2025