A multicenter validation of the revised version of the Milan system for reporting salivary gland cytology (MSRSGC)

Mazzola, Francesco; Tomasoni, Michele; Mocellin, Davide; Dale, Marianne; Iandelli, Andrea; Carobbio, Andrea Luigi Camillo; Marchi, Filippo; Filauro, Marta; Petruzzi, Gerardo; Massa, Barbara; Facchetti, Mattia; Battocchio, Simonetta; Marandino, Ferdinando; Lombardi, Davide; Pichi, Barbara; Pellini, Raul; Nicolai, Piero; Peretti, Giorgio

doi:10.1016/j.oraloncology.2020.104867

Cited by 17 publications

(32 citation statements)

References 31 publications

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“…Previous studies reporting on the ROMs for MSRSGC categories have shown variation in the distribution of ROMs, especially in the MSRSGC I, II, III, and IVb categories 5‐14 . These studies are summarized in Table 6.…”

Section: Discussionmentioning

confidence: 98%

“…Previous studies reporting on the ROMs for MSRSGC categories have shown variation in the distribution of ROMs, especially in the MSRSGC I, II, III, and IVb categories. 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 These studies are summarized in Table 6 . Only studies that included at least 200 patients with histopathological confirmation were included in this summary.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Numerous studies have assessed the accuracy of cytopathological evaluation using the MSRSGC tool; these have concluded that this tool can make a valuable contribution to the management of a parotid gland mass. 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 Unfortunately, most of these studies have lacked large groups and have been mostly single‐institution or bi‐institutional studies. As a result, the claim has been made that large‐scale, multicenter studies are imperative for testing the reliability and validity of the MSRSGC classification.…”

Section: Introductionmentioning

confidence: 99%

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Accuracy of parotid gland FNA cytology and reliability of the Milan System for Reporting Salivary Gland Cytopathology in clinical practice

Reerds

Grunsven

Hoogen

et al. 2021

Cancer Cytopathology

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BACKGROUND: Differentiating between malignant and benign salivary gland tumors with fine-needle aspiration cytology (FNAC) can be challenging. This study was aimed at testing the validity of the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) and at assessing possible differences in the sensitivity and specificity of parotid gland FNAC between dedicated head and neck (H&N) centers, subdivided into head and neck oncology centers (HNOCs) and head and neck oncology affiliated centers (HNOACs), and general hospitals (GHs). METHODS: The Dutch Pathology Registry (PALGA) database was searched for patients who had undergone a salivary gland resection between January 1, 2006, and January 1, 2017, and had a preoperative FNAC result. The FNAC reports were retrospectively assigned to MSRSGC categories. The risk of malignancy (ROM) was calculated for each category. The sensitivity and specificity for diagnosing malignancy were calculated and compared among HNOCs, HNOACs, and GHs. RESULTS: In all, 12,898 FNAC aspirates were evaluated. The ROMs for each category were as follows: 12.5% in MSRSGC I, 10.3% in MSRSGC II, 29% in MSRSGC III, 2.3% in MSRSGC IVa, 28.6% in MSRSGC IVb, 83% in MSRSGC V, and 99.3% in MSRSGC VI. The sensitivity of FNAC was highest in HNOCs (88.1%), HNOACs scored lower (79.7%), and GHs had a sensitivity of 75.0%. CONCLUSIONS: The MSRSGC is a valid tool for reporting parotid gland FNAC; therefore, these results strongly advocate its use. On the basis of the higher sensitivity of FNAC in dedicated H&N centers, the authors recommend that GHs use the presented management strategies to help to minimize the chances of a preoperative misdiagnosis. Cancer Cytopathol 2021;0:1-10.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Accuracy of parotid gland FNA cytology and reliability of the Milan System for Reporting Salivary Gland Cytopathology in clinical practice

Reerds

Grunsven

Hoogen

et al. 2021

Cancer Cytopathology

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“…Rivera Rolon et al reviewed 208 salivary gland FNAs in 2020 that confirmed these findings and suggested a diagnostic accuracy of 94.4% when distinguishing benign versus malignant pathology 7 . Multiple other retrospective analyses show that the MSRSGC appears to be an accurate and effective tool to categorize indeterminate salivary gland FNAs 8,10,11 . Milan 3—atypia of undetermined significance—seems to have the most variable rate of malignancy; Jalaly et al cite it at 27.6%–61%.…”

Section: Discussionmentioning

confidence: 99%

Milan system for reporting salivary gland cytopathology: Adoption and outcomes in a community setting

et al. 2022

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Background: Milan system for reporting salivary gland cytopathology (MSRSGC) was introduced to standardize reporting of salivary gland cytopathology. Methods: A retrospective review of ultrasound-guided fine needle biopsy of salivary gland lesions was performed between January 2018 and May 2021 at a community otolaryngology practice. Diagnostic accuracy and rate of diagnostic sialoadenectomy were calculated.Results: A total of 203 FNAs (fine needle aspiration) were performed in 184 patients. MSRSGC was utilized in 87/203 cytopathology reports, with a diagnostic accuracy of 84%. Descriptive reporting was used in 115 FNAs, with a diagnostic accuracy of 89% (p = 0.68). Sialoadenectomy rate was 41% for MSRSGC compared to 36% in descriptive cytopathology (p = 0.48).Conclusions: MSRSGC is as accurate as descriptive cytopathology and the rate of diagnostic sialoadenectomy between both groups is similar in our community. The MSRSGC brings uniformity and standardization to the FNA reporting process.

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The Milan system for reporting salivary gland cytopathology—A single‐center study of 2156 cases

et al. 2023

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Background: Fine-needle aspiration cytology (FNAC) represents an important diagnostic tool for the workup of salivary gland (SG) lesions. The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is a six-tiered system for standardizing diagnoses and improvement of communication between pathologists and clinicians, providing risk of malignancy (ROM) rates for every category.The aims of the present study were (i) to validate the use of MSRSGC in a large series of SG FNAC in a tertiary center in Switzerland, (ii) to determine ROM for each category and compare them with data from MSRSGC and similar studies, and (iii) to investigate whether there were relevant differences of non-diagnostic results between fine-needle aspirations (FNA) performed by cytopathologists compared to non-cytopathologists. Methods:The files of the department of Pathology in the University Hospital Zurich (UHZ) were searched for SG FNAC between 2010 and 2019. The MSRSGC guidelines were applied retrospectively. Furthermore, ROM, risk of neoplasia (RON), sensitivity, and specificity were calculated based on the cases with histopathological follow-up. Results: A total of 2156 SG FNAC including 753 cases with histopathological follow-up were evaluated. Generally, ROM was within the range of values provided by MSRSGC, with some minor deviations. Sensitivity was 94.6%, and specificity was 99.3%. Conclusions:Our study confirms the usefulness of MSRSGC. In addition, it provides a detailed insight into the wide spectrum of SG FNAC. Finally, we showed that the rate of non-diagnostic FNA was significantly lower in FNAs performed by cytopathologists compared to non-cytopathologists. K E Y W O R D Scytology, fine-needle aspiration (FNA), Milan system for reporting salivary gland cytopathology (MSRSGC), risk of malignancy (ROM), salivary gland tumors

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A multicenter validation of the revised version of the Milan system for reporting salivary gland cytology (MSRSGC)

Cited by 17 publications

References 31 publications

Accuracy of parotid gland FNA cytology and reliability of the Milan System for Reporting Salivary Gland Cytopathology in clinical practice

Accuracy of parotid gland FNA cytology and reliability of the Milan System for Reporting Salivary Gland Cytopathology in clinical practice

Milan system for reporting salivary gland cytopathology: Adoption and outcomes in a community setting

The Milan system for reporting salivary gland cytopathology—A single‐center study of 2156 cases

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