title: ARFI quantitative elastography of the submandibular glands. Normal measurements and the diagnosis value of the method in radiation submaxillitis.
abstract: OBJECTIVE
  Evaluation of Acoustic Radiation Force Impulse Imaging (ARFI) elastography performance in predicting the elasticity of the submandibular glands in normal situations and after radiation therapy.
  
  
  METHODS
  A number of 54 normal submandibular glands from 27 voluntary subjects and 33 pathological submandibular glands (radiation submaxillities) from 18 patients who had undergone radiation therapy for various cervical and facial oncological conditions were included in study. All the patients had undergone a B mode ultrasonography (Tissue Harmonic Imaging, 8-14 MHz) while the submandibular volume was determined and subsequently an ARFI examination while the shear wave velocity (SWV) was measured (in the central, peripheral and subcapsular areas, with the results expressed in m/s).
  
  
  RESULTS
  In the volunteers' group the mean value of the SWV of the left submandibular gland was 1.68 ± 0.46 m/s, determined in the centre of the gland, 1.88 ± 0.4 m/s in the periphery (corresponding to the subcapsular parenchyma) and the SWV of the right submandibular gland was 1.74 ± 0.35 m/s (centrally) and 1.84 ± 0.43 m/s in the periphery. The mean value of all measurements was 1.82 ± 0.41 m/s. The mean volume of the glands was 7.97 ± 2.63 cm3. In the group of patients who had underwent radiation therapy (at least 35Gy), the mean value of the SWV was 2.24 ± 0.49 m/s centrally and 2.1 ± 0.58 m/s in the periphery on the left and 1.99 ± 0.5 m/s centrally and 2.21 ± 0.52 m/s in the periphery on the right. The mean value of all the measurements was 2.13 ± 0.52 m/s and the mean volume of the gland was 5.95 ± 4.16 cm3.
  
  
  CONCLUSIONS
  Elastography using ARFI technique is a valid examination in the evaluation of the normal and pathological submandibular gland stiffness. The values of the shear wave velocities that correspond to a normal stiffness, determined through the ARFI technique, are similar in the two glands. After cervical and facial radiation therapy the values of the SWV are increased, indicating a change in the consistency of the gland thus implying a structural transformation. The ARFI technique can be used in the evaluation of the salivary glands pathology.
authors: 1Department of Maxillofacial Surgery, Iuliu Haţeganu University of Medicine and pharmacy, Cluj Napoca, România.
authors: Alexandru Florin
authors: AF
authors: Badea
authors: Attila
authors: A
authors: Tamas Szora
authors: Elisabeta
authors: E
authors: Ciuleanu
authors: Ioana
authors: I
authors: Chioreanu
authors: Grigore
authors: G
authors: Băciuţ
authors: Monica
authors: M
authors: Lupşor Platon
authors: Radu
authors: R
authors: Badea
mesh_terms: D000328:Adult; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D011832:Radiation Injuries / Q000000981:diagnostic imaging* / Q000209:etiology*; D020266:Radiotherapy, Conformal / Q000009:adverse effects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012793:Sialadenitis / Q000000981:diagnostic imaging* / Q000209:etiology*; D013364:Submandibular Gland Diseases / Q000000981:diagnostic imaging* / Q000209:etiology*; D055815:Young Adult