Distinguishing benign from malignant parotid gland tumours: low-dose multi-phasic CT protocol with 5-minute delay

Jin, Guanqiao; Su, Danke; Xie, Dong; Zhao, Wei; Liu, L. D.; Zhu, Xinli

doi:10.1007/s00330-011-2101-y

Cited by 30 publications

(27 citation statements)

References 21 publications

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“…Although the majority of parotid lesions are benign, surgery represents the treatment of choice (3). However, due to the nearness of the facial nerve, it is very important to know the anatomical relationships in order to perform a meticulous surgical technique (6,9). Furthermore, it is very important to preoperatively know the aggressiveness of the tumour through a correct imaging assessment.…”

Section: Discussionmentioning

confidence: 99%

“…Although MRI has demonstrated a better soft tissue differentiation in parotid lesion evaluation (7), contrast-enhanced CT provides useful information in tumour characterization as well as their relationships to nearby structures (8). Great importance has been given to CT imaging in differentiating salivary gland tumours basing on lesion enhancing pattern but very little has been published about this issue if compared to studies concerning the MRI findings (7)(8)(9)(10)(11). Furthermore, the improvement of multiphasic CT scanner has led to optimized protocols with increased lesion conspicuity and better definition between tumour and surrounding normal tissues.…”

Section: Original Articlementioning

confidence: 99%

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Delayed enhancement in differential diagnosis of salivary gland neoplasm

et al. 2019

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Background: Multi-phasic Computed Tomography (CT) evaluation allows to study the enhancement features of parotid gland masses. The aim of our study was to evaluate the role of delayed enhancement in the characterization of different histologic types of parotid tumours. Methods: Forty-eight patients (22 male and 26 female) with at least one parotid gland tumor, were included in our study. Multi-phase CT images were obtained before and 30, 120 s and 8 minutes after intravenous contrast injection. The images were evaluated by two radiologists for lesion enhancement degree. A quantitative assessment was performed using a region of interest on each lesion and density changes between different phases were compared. The tumoral enhancement ratio was calculated between the 8 minutes delayed and the early (30 s) phase. The pathological diagnosis was confirmed in all patients after surgery. Results: All patients had unilateral lesion for a total of 48 lesions. Twenty-eight were pleomorphic adenomas, 15 Warthin's tumours and 5 carcinomas. All Warthin tumours showed a rapid contrast enhancement at the early phase (30 sec) followed by a progressive wash-out during the delayed scans. Most of pleomorphic adenomas (89.2%) showed the highest density at the 8-minutes delayed phase. Malignant tumours showed slower contrast enhancement and 3 out of 5 (60%) showed a marked decrease at the 8 minutes delayed phase while the remaining 2 (40%), did not show any density reduction. The tumoral enhancement ratio was significantly different between Warthin tumours and pleomorphic adenomas and between Warthin's and malignant tumours. Conclusions: Multi-phasic CT examination with 8 minutes delayed acquisition has shown to be useful in parotid gland lesion differentiation.

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Section: Discussionmentioning

confidence: 99%

Section: Original Articlementioning

confidence: 99%

Delayed enhancement in differential diagnosis of salivary gland neoplasm

et al. 2019

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“…2,5 A study found that the percentage washout ratios in contrast materialenhanced CT may reflect various characters of parotid gland neoplasms and assist in differentiating benign from malignant tumours. 6 However, conventional CT enhanced scanning can only provide two or three phases enhanced pattern of the lesions, and it does not provide absolute quantification of perfusion changes in parotid gland lesions. CT perfusion (CTP) imaging involves the non-invasive measurement of blood volume of the lesions at the capillary level.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of CT perfusion imaging for parotid neoplasms

Dong

Gw²,

Sw³

et al. 2014

Dentomaxillofacial Radiology

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Objectives: To assess the value of CT perfusion imaging in the differentiation of different histological categorization of benign tumours from malignant tumours in patients with parotid neoplasms. Methods: CT perfusion was successfully performed in 62 patients with parotid neoplasms whose diagnoses were confirmed by surgery or biopsy. The software generated a tissue time-density curve (TDC) and measured blood volume, blood flow, mean transit time and capillary permeability surface product. One-way ANOVA and receiver operating characteristic curves were used to analyse the difference and diagnostic efficacies of all perfusion data between each one of the benign tumours and malignancies. Statistical significance was assigned at the 5% level. Results: Pleomorphic adenomas mainly had a gradually ascending TDC. Warthin tumours showed a fast ascent followed by a fast descent. The TDC of basal cell adenomas had a fast ascension followed by a plateau, then a gradual descent. Malignant tumours mainly showed a rapidly ascending curve with a stable plateau. Significant differences were observed in blood flow, blood volume and mean transit time between pleomorphic adenomas and malignant tumours (p , 0.05) as well as in blood flow and blood volume between the Warthin tumours, the basal cell adenomas and the malignant tumours (p , 0.05). Differences in permeability surface between the basal cell adenomas and malignant tumours were significant (p , 0.01). Conclusion: CT perfusion of parotid gland could provide TDC and perfusion data, which were useful in the differentiation of different histological benign tumours and malignant tumours in the parotid gland.

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“…To our knowledge, they always present as painless, slowgrowing lumps and there are no specific manifestations in laboratory and traditional maging examinations. Even though, previous studies showed that multiple lesions, smoking and olderly male are helpful to suggest WTs, there are still many overlapping features are confusing and difficult to diagnosis and claify before operation [3][4][5] . Fine needle aspiration (FNA) is considered to be gold standard for parotid tumors diagnosis, but has some limitations, even under optimum conditions and may be associated with poor levels of diagnostic accuracy [6] .…”

Section: Introductionmentioning

confidence: 99%

“…Dual or three phases enhanced examination has been currently the primarily method for the assessment of the parotid tumors [3,4,9] . Based on previous literatures [9][10][11] , it is known that washout time (or washout ratio) of contrast agents in the tumors could provide many valuable physiopathology information and help to differential diagnosis among of pariod gland lesions.…”

Section: Introductionmentioning

confidence: 99%