Neither MRI, CT nor US is superior to diagnose tumors in the salivary glands--an extended case study.

Claudia Rudack,Sabine Jörg,Oliver Thiede,Stephan Kloska,Wolfgang Stoll

doi:10.1186/1746-160x-3-19

Claudia Rudack, Sabine Jörg + Show 3 more

Open Access

https://doi.org/10.1186/1746-160x-3-19

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Journal: Head & Face Medicine	Publication Date: Apr 3, 2007
Citations: 46	License type: CC BY 2.0

Affiliation: University Hospital Münster

Abstract

ObjectivesUltrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI) are the most common radiological procedures for the diagnosis of tumor-like lesions of the salivary glands. The aim of the present study was to determine whether MRI or CT provide additional information besides that delivered by US.Study design/Methods109 patients with a tumor-like lesion of the salivary glands underwent surgery. MRI and CT were arranged in 73 and in 40 patients respectively, whereas all 109 patients were prospectively diagnosed by US. The results of CT, MRI and US were compared with the histological outcome. Furthermore, the recent rise in the number of CT and MRI studies was investigated.ResultsOn CT and MRI, there was no rise in the percentage of malignant tumors or advanced surgical procedures. In respect of the radiological assessment of the lesion (benign/malignant) and the correct diagnosis, CT, MRI and US were comparable in terms of sensitivity, specificity and accuracy. No significant difference was found in the Chi-square test (p > 0.05).ConclusionThe evaluation of the preoperative results of CT, MRI and US revealed no advantage for CT or MRI; these procedures are only required in specific cases. An update or revision of the current preoperative diagnostic management is deemed necessary.

Highlights

Tumor-like lesions of the salivary glands constitute 3% to 6% of all head-and-neck tumors
On computed tomography (CT) and magnetic resonance imaging (MRI), there was no rise in the percentage of malignant tumors or advanced surgical procedures
In respect of the radiological assessment of the lesion and the correct diagnosis, CT, MRI and US were comparable in terms of sensitivity, specificity and accuracy

Summary

Introduction

Tumor-like lesions of the salivary glands constitute 3% to 6% of all head-and-neck tumors. Besides clinical examination (palpation), salivary gland tumors – malignant or benign – are diagnosed by imaging procedures such as computed tomography (CT), magnetic resonance imaging (MRI) or ultrasonography (US); sialography has become less popular. Most guidelines of ENT task forces [2] recommend ultrasound as the initial imaging modality of choice for the assessment of palpable abnormalities of the salivary gland. US can be used to establish the need for imaging procedures (CT or MRI), in those lesions (page number not for citation purposes). Head & Face Medicine 2007, 3:19 http://www.head-face-med.com/content/3/1/19 showing malignant features on ultrasonography, or large masses whose extent is difficult to assess with US, if located in the deep lobe [8,14][16]. Irregular tumor margins or invasion into adjacent structures on CT suggests malignancy, a benign tumor may well mimic a malignant lesion on CT

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