Sonoelastography of parotid gland tumours: initial experience and identification of characteristic patterns

Klintworth, Nils; Mantsopoulos, Konstantinos; Zenk, Johannes; Psychogios, Georgios; Iro, Heinrich; Bozzato, Alessandro

doi:10.1007/s00330-011-2344-7

Cited by 71 publications

(76 citation statements)

References 37 publications

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“…Klintworth et al evaluated 57 parotid mass lesions with US and US elastography and claimed that blurred edge is the sole criteria to differentiate malignant and benign tumors from each other in B mode US (13). Blurred edge was defined in 28.6% of malignant lesions where there was not any in benign lesions in our study, but this finding was not statistically significant (P = 0.06).…”

Section: Sonoelastography Is a New Imaging Technique That Determines contrasting

confidence: 66%

Sonoelastographic Features of Major Salivary Gland Tumors and Pathology Correlation

Farasat¹,

Ovalı

Düzgün

et al. 2017

Iran J Radiol

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Objectives: To investigate the diagnostic efficiency of elastography in differentiation of malignant and benign tumors by evaluating salivary gland masses in means of their elastography scores and strain ratios. Patients and Methods: Twenty five patients with salivary gland mass lesions were detected through B-mode ultrasonography, Doppler ultrasonography, strain elastography and their strain ratios were calculated. The results were compared with histopathologic results. Results: Twenty five patients had 27 lesions consisting of seven malignant and 20 benign lesions. Mann Whitney U test, ROC analysis, Fisher test and Chi square tests were used statistically. Mean strain rates were calculated as 2.26 ± 0.29 in the benign group and 2.02 ± 0.59 in the malignant group. There was no statistically significant difference between the two groups (P = 0.698). Elastography score was calculated as mean 2.4 ± 0.94 in the benign group and mean 2.28 ± 0.38 in the malignant group. There was no statistically significant difference between the two groups (P = 0.708). Accepting the strain rate as 0.89; sensitivity of elastography in differentiating malignant from benign lesions is 71%, and the specificity is 50%. However, the area under the ROC curve is 0.55, which is not statistically significant (P = 0.699). Conclusion: Elastography is a supporting method for B-mode ultrasonography in the differentiation of benign and malignant salivary gland masses. However, the overlap of elastographic findings is evident in benign and malignant masses. Care should be taken to have tissues with similar stiffness under the reference tissue and the lesions in elastographic evaluation of the superficial mass. We have not met a study that has pointed out the importance of stiffness of the tissue located beneath the lesion that may affect the elastography results in the literature. In this respect our study is unique.

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Section: Sonoelastography Is a New Imaging Technique That Determines contrasting

confidence: 66%

Sonoelastographic Features of Major Salivary Gland Tumors and Pathology Correlation

Farasat¹,

Ovalı

Düzgün

et al. 2017

Iran J Radiol

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“…However, there is limited evidence for the usefulness of USE in the differential diagnosis of parotid tumors [21,[37][38][39][40]. A typical sonoelastographic pattern for pleomorphic adenomas could not be demonstrated by Dumitriu et al [21].…”

Section: Discussionmentioning

confidence: 99%

Prospective evaluation of Quasistatic Ultrasound Elastography (USE) compared with Baseline US for parotid gland lesions: preliminary results of elasticity contrast index (ECI) evaluation

et al. 2017

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Aims: To assess the diagnostic value of elasticity contrast index (ECI) elastography, in comparison with conventional ultrasound for the differentiation of benign and malignant parotid lesions. Material and methods: Sixty-three consecutive patients with parotid gland tumors, treated surgically at a single tertiary center were enrolled. Ultrasound evaluation consisted of B-mode, color-Doppler and quasistatic ultrasound elastography (USE), conducted with the ECI technique. For each lesion the echogenicity, margins, vascularization, and capsulation were considered to determine benign or malignant lesions. Histology was considered the gold standard. Results: Using conventional parameters, the observer suggested malignant lesions in 20 cases and benign lesions in 43 cases (accuracy: 61.8%). ECI>3.5 alone was the most accurate parameter (accuracy: 90.5%), with sensitivity of 93.7% and specificity of 89.4%. However, when combined with the other US criteria, no statistically significant diagnostic accuracy improvement was achieved. Conclusions: Our results show that USE with ECI index measurement can help to discriminate preoperatively benign from malignant lesions, with the exception of pleomorphic adenoma which is stiff. We suggest that USE can be used as an additional tool to conventional US evaluation of salivary gland lesions.

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“…[4][5][6][7][8][9] These reports indicated an especially variable appearance of pleo- morphic adenomas on elastography. [6][7][8]10 Although benign tumors other than pleomorphic adenomas appeared softer in qualitative elastographic studies, some appeared softer and others harder.…”

Section: Discussionmentioning

confidence: 86%

“…[6][7][8]10 Although benign tumors other than pleomorphic adenomas appeared softer in qualitative elastographic studies, some appeared softer and others harder. 4,8,9 In a study by Bhatia et al, 6 pleomorphic adenomas appeared stiffer than other benign parotid gland tumors, with a wide distribution of maximum elasticity values (range, 16.4-214.8 kPa). 6 These data show that SWE cannot differentiate benign parotid gland tumors from malignant counterparts by measurement of the maximum shear elastic modulus.…”

Section: Discussionmentioning

confidence: 95%

“…1-3 However, elasticity imaging (both by qualitative and quantitative elastographic methods) is not definitive in distinguishing benign from malignant lesions in the salivary glands. [4][5][6][7][8][9] In particular, the appearance of pleomorphic adenomas Deniz Cebi Olgun, MD, Fatih Kantarci, MD, Umit Taskin, MD, Fahrettin Kilic, MD, Mehmet Faruk Oktay, Serdar Altinay, MD, Nuray Kepil, MD, Ibrahim Adaletli, MD, Mehmet Ada, MD, Ismail Mihmanli, MD Received July 2, 2013, Objectives-The purpose of this study was to evaluate whether the relative proportions of stromal to cellular components of pleomorphic adenomas have an effect on the shear elastic modulus determined by shear wave elastography (SWE).Methods-This study was approved by the Ethics Committee of our institution and performed between September 2011 and December 2012. Thirty-five patients who underwent surgery for a parotid mass were included in the study.…”

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confidence: 99%

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Relative Proportions of Stromal to Cellular Components of Pleomorphic Adenomas

Olgun

Kantarcı

Taşkın

et al. 2014

J of Ultrasound Medicine

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Determination With Shear Wave Elastography easurement of tissue stiffness by sonography is a relatively new and expanding field of research. The principle theory in elastography is that malignant tumors are stiffer than benign ones. Preliminary evidence suggests that elastographic techniques may have a discriminatory value for detecting malignancies in the breast and thyroid gland. 1-3 However, elasticity imaging (both by qualitative and quantitative elastographic methods) is not definitive in distinguishing benign from malignant lesions in the salivary glands. [4][5][6][7][8][9] In particular, the appearance of pleomorphic adenomas Deniz Cebi Olgun, MD, Fatih Kantarci, MD, Umit Taskin, MD, Fahrettin Kilic, MD, Mehmet Faruk Oktay, Serdar Altinay, MD, Nuray Kepil, MD, Ibrahim Adaletli, MD, Mehmet Ada, MD, Ismail Mihmanli, MD Received July 2, 2013, Objectives-The purpose of this study was to evaluate whether the relative proportions of stromal to cellular components of pleomorphic adenomas have an effect on the shear elastic modulus determined by shear wave elastography (SWE).Methods-This study was approved by the Ethics Committee of our institution and performed between September 2011 and December 2012. Thirty-five patients who underwent surgery for a parotid mass were included in the study. The maximum shear elastic modulus of the mass was measured by SWE. Pleomorphic adenomas were histopathologically subdivided into stroma-poor, intermediate-stroma, and stroma-rich tumors based on the relative proportion of stromal to cellular components.Results-The maximum shear elastic modulus values of the pleomorphic adenomas ranged from 12.6 to 291.9 kPa (mean ± SD, 120.9 ± 92.8 kPa). The Friedman test revealed a statistically significant relationship between the stromal amount and maximum shear elastic modulus (P < .001). Stroma-poor adenomas (mean, 32.3 ± 27.7 kPa; range, 12.6-81.1 kPa) were softer on SWE than stroma-rich adenomas (mean, 174.1 ± 48.4 kPa; range, 92.7-217.2 kPa; P = .009). No such significant difference was detected between stroma-poor and intermediate-stroma tumors (mean, 146.3 ± 106.1 kPa; range, 19.1-291.9 kPa; P = .062) or between intermediate-stroma and stroma-rich tumors (P = .465).Conclusions-Shear wave elastography depicts pleomorphic adenomas with a variable appearance, which is due to the relative proportions of stromal to cellular contents in the tumors.

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Sonoelastography of parotid gland tumours: initial experience and identification of characteristic patterns

Cited by 71 publications

References 37 publications

Sonoelastographic Features of Major Salivary Gland Tumors and Pathology Correlation

Sonoelastographic Features of Major Salivary Gland Tumors and Pathology Correlation

Prospective evaluation of Quasistatic Ultrasound Elastography (USE) compared with Baseline US for parotid gland lesions: preliminary results of elasticity contrast index (ECI) evaluation

Relative Proportions of Stromal to Cellular Components of Pleomorphic Adenomas

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