The Role of Real‐Time Elastography in the Differential Diagnosis of Salivary Gland Tumors

Abstract

Objectives-The aim of the study was to scrutinize the value of qualitative elastography in the diagnosis of salivary gland masses.Methods-Sixty patients were enrolled in this prospective study. Patients aged between 1 and 91 years (mean age, 48.8 ± 20.48) with a salivary gland mass were studied with real-time elastography. All patients were examined by 1 examiner, blinded to all relevant data. On elastography, masses were scored into 4 types according to their stiffness compared to normal tissue. Scores of 3 and 4 were accepted as signs of malignancy. Sensitivity, specificity, and positive and negative predictive value were calculated for elastography in verifying malignancy.Results-Forty-two percent of the masses were located in the parotid, and the rest in submandibular gland. The diameter of the lesions varied between 12 and 60 mm (mean, 24.36 ± 11.98 mm). Forty-four masses were benign (73%), and among them the majority were inflammatory lesions (31 of 60; 51.7%). There were 16 malignant lesions (27%). On elastography, not only all malignant lesions but 15 benign lesions were scored as 3 to 4. All masses scored as 1 to 2 were benign. Sensitivity was 100%; specificity, 66%; positive predictive value, 52%; and negative predictive value, 100%. When only Score 4 lesions were accepted as malignant, these values became 75%, 77%, 55%, and 90%, respectively.Conclusions-Elastography alone cannot be used to discriminate malignant from benign in the evaluation of salivary gland lesions. However, with its high negative predictive value, it may be used as an adjunct tool to increase the diagnostic value of ultrasonography.

Ultrasonography techniques in the preoperative diagnosis of parotid gland tumors – an updated review of the literature

“…Larger prospective studies are needed to determine the value of this investigation. USE recorded a pooled Se of 67%, a Sp of 64% and a diagnosis odds ratio of 8.00 in a meta-analysis [34] that evaluated the value of this investigation in the differential diagnosis of parotid tumors [9,26,34,35,36].…”

Clinical Utility of Qualitative Elastography Using Acoustic Radiation Force Impulse for Differentiating Benign from Malignant Salivary Gland Tumors

“…The diagnostic accuracy of conventional SE in this study tended to be lower than that reported previously (Cortcu et al 2018;Karaman et al 2019). The eSie Touch imaging used in this study as conventional SE was selected on the basis of numerical parameters (strain quality indicator >50).…”

“…However, previous studies, with diagnostic accuracies >80%, may have had image selection bias. It is also possible that the wide range of diagnostic accuracy of conventional SE published in previous reports (55.4%À94.0%) might have been caused by image selection bias and the experience level and skill of examiners (Bhatia et al 2010;Dumitriu et al 2011;Celebi and Mahmutoglu 2013;Li et al 2016;Cortcu et al 2018;Karaman et al 2019).…”

“…Thus, the accuracy of conventional SE examination depends on the examiner's experience level and predisposition for image selection (Westerland and Howlett 2012). In fact, the diagnostic accuracy of conventional SE for differentiating benign and malignant salivary gland tumors varies from 55.4%À94.0% in several published reports (Bhatia et al 2010;Dumitriu et al 2011;Celebi and Mahmutoglu 2013;Li et al 2016;Cortcu et al 2018;Karaman et al 2019).…”

Sonoelastic response of median nerve to rehabilitation in carpal tunnel syndrome

“…The cross-sectional area (CSA) of the median nerve within the carpal tunnel inlet and outlet is the parameter of interest measured to reflect the severity of CTS ( 7 ) . As an extension to conventional US, sonoelastography (SE) has been introduced to map the local distribution of elasticity in biological tissues ( 8 , 9 ) .…”