Preoperative Multiparametric Ultrasound and Fine Needle Aspiration Cytology evaluation of parotid gland tumors: which is the best technique?

Abstract

Aims: To evaluate the pre-surgical diagnostic value of Multiparametric Ultrasound (MPUS) and Fine Needle Aspiration Cytology (FNAC) in differentiating parotid gland tumors, comparing the results with histology. Materials and methods:The study enrolled 84 patients with parotid gland lesions surgically treated in a single tertiary center and evaluated by MPUS. Each patient underwent FNAC. Histological examination was considered the gold standard. Results: Histology identified 62 benign tumors and 22 malignancies. In the differential diagnosis between malignant and benign lesions, B-mode Ultrasound (US), Color-Doppler US, Contrast-Enhanced US (CEUS), Elastography (USE) and FNAC showed the following values of sensitivity: 82%, 81%, 86%, 77%, 73% respectively; specificity: 97%, 61%, 95%, 71%, 97% respectively; PPV: 90%, 43%, 86%, 50%, 89% respectively; NPV: 93%, 90%, 95%, 88%, 91% respectively; and accuracy: 89%, 71%, 90%, 78%, 84% re-spectively. Conclusions: CEUS proved to be a valid and accurate method for identifying malignant tumors of parotid gland; the combination of B-mode US with CEUS showed similar diagnostic accuracy, but better sensitivity than CEUS taken alone. USE did not improve the diagnostic performance of the B-mode US, alone or in association with CEUS; however, it revealed the highest diagnostic accuracy in the differentiation between benign lesions. FNAC demonstrated lower values in comparison with CEUS and with USE. Therefore, according to our study, MPUS could be proposed as a valid alternative to FNAC.

Advances in clinical examination of lacrimal gland

“…MRI can also be combined with fine-needle aspiration cytology (FNAC) to enhance diagnosis. Imaging techniques are easily and safely applied to lesions ( 23 , 24 ). Ultrasound-guided puncture biopsy is safe and effective for adrenal lacrimal lesions, including identifying benign and malignant causes and reducing or avoiding invasive surgical biopsies in most patients ( 25 ).…”

Correlations between Contrast-Enhanced Ultrasound Imaging and Histopathological Results in Salivary Gland Lesions

“…It appears to be a promising diagnostic tool, especially in combination with clinical complaint assessment [ 4 , 5 ]. Guiban et al in 2021 suggested that “the combination of B-mode US and CEUS greatly improved the sensitivity of the CEUS performed individually and presented remarkable accuracy, with the potential to reduce the number of invasive procedures” [ 6 ]. Saito et al in 2020 reported that “CEUS is a simple, safe, and noninvasive examination for patients that can be performed conveniently in real-time and could help differentiate PMA from WT in salivary glands” [ 7 ].…”

“…Saito et al in 2020 reported that “CEUS is a simple, safe, and noninvasive examination for patients that can be performed conveniently in real-time and could help differentiate PMA from WT in salivary glands” [ 7 ]. Papers present in the literature suggest that there is a constant need for further studies with large patient groups [ 4 , 5 , 6 , 7 ]. The authors had access to a relatively large group of patients who underwent preoperative contrast-enhanced ultrasound (CEUS) examination.…”