title: The relative value of fine-needle aspiration and imaging in the preoperative evaluation of parotid masses.
abstract: BACKGROUND
  To establish the sensitivity, specificity, and accuracy of imaging and fine-needle aspiration (FNA), alone or in combination, in distinguishing benign from malignant histologic findings for parotid lesions.
  
  
  METHODS
  Retrospective blinded review of preoperative imaging and FNA studies of parotid masses and comparison with histologic findings after excision.
  
  
  RESULTS
  Forty-eight patients were identified (13 with CT, 35 with MRI); 23 (48%) of the lesions were malignant, 25 (52%) were benign. MRI, CT, and FNA misclassified 17%, 46%, and 21% of the lesions, respectively. The sensitivity/specificity/accuracy of these tests for detecting malignant lesions were as follows: MRI (88%,77%,83%), CT (100%,42%, 69%), and FNA (83%,86%,85%) and were not significantly different. Combinations of imaging and FNA were not significantly better in detecting malignancy.
  
  
  CONCLUSIONS
  Imaging and FNA are comparable in their ability to correctly identify malignant parotid lesions preoperatively. Combining these two modalities yields no advantage in terms of specificity, sensitivity, or accuracy of a malignant diagnosis.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Oregon Health Sciences University, 3181 S.W. Sam Jackson Park Road, PV-01, Portland, Oregon 97201-3098, USA.
authors.forename: S
authors.initials: S
authors.lastname: Bartels
authors.forename: J M
authors.initials: JM
authors.lastname: Talbot
authors.forename: J
authors.initials: J
authors.lastname: DiTomasso
authors.forename: E C
authors.initials: EC
authors.lastname: Everts
authors.forename: P E
authors.initials: PE
authors.lastname: Andersen
authors.forename: M K
authors.initials: MK
authors.lastname: Wax
authors.forename: J I
authors.initials: JI
authors.lastname: Cohen
mesh_terms: D001707:Biopsy, Needle; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010307:Parotid Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D011300:Preoperative Care; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed