OBJECTIVE: Histology of parotid tumors determines the extent of surgery. The aim was to test ultrasound (US) contrast enhancer-kinetics to identify histologic entities, possibly being superior to qualitative morphological parameters. STUDY DESIGN: In a cross-sectional assessment of ultrasound diagnosis, the subjective US-classification was compared with contrast analysis with histology as gold standard. SUBJECTS AND METHODS: A total of 64 male and 61 female patients with a mean age of 54 years were included, with 13 malignant tumors. These were classified with US morphology, then time-dependent contrast medium analysis. RESULTS: A total of 92.8% of tumors were classified correctly as malignant or benign. The sensitivity, specificity, positive- and negative-predictive values were 66.7%, 86.3%, 60.6%, and 89.1% for differentiating Warthin tumors, but only 46.2%, 98.2%, 75%, and 94% for malignant lesions. Contrast parameters yielded significant parameters for benign tumors, not for malignant entities. CONCLUSION: Although contrast medium analysis provided statistical criteria, these, however, do not possess the ability to improve the diagnostic prediction of tumor histology. Neither the morphologic classification nor contrast medium analysis was able to identify a malignant lesion sufficiently.
OBJECTIVE: Histology of parotid tumors determines the extent of surgery. The aim was to test ultrasound (US) contrast enhancer-kinetics to identify histologic entities, possibly being superior to qualitative morphological parameters. STUDY DESIGN: In a cross-sectional assessment of ultrasound diagnosis, the subjective US-classification was compared with contrast analysis with histology as gold standard. SUBJECTS AND METHODS: A total of 64 male and 61 female patients with a mean age of 54 years were included, with 13 malignant tumors. These were classified with US morphology, then time-dependent contrast medium analysis. RESULTS: A total of 92.8% of tumors were classified correctly as malignant or benign. The sensitivity, specificity, positive- and negative-predictive values were 66.7%, 86.3%, 60.6%, and 89.1% for differentiating Warthin tumors, but only 46.2%, 98.2%, 75%, and 94% for malignant lesions. Contrast parameters yielded significant parameters for benign tumors, not for malignant entities. CONCLUSION: Although contrast medium analysis provided statistical criteria, these, however, do not possess the ability to improve the diagnostic prediction of tumor histology. Neither the morphologic classification nor contrast medium analysis was able to identify a malignant lesion sufficiently.
Authors: Kunwar S S Bhatia; Darshana D Rasalkar; Yim-Ping Lee; Ka-Tak Wong; Ann D King; Hok-Yuen Yuen; Anil T Ahuja Journal: Eur Radiol Date: 2010-04-21 Impact factor: 5.315