Real-time ultrasound elastography for the differentiation of malignant and benign masses in the head and neck.
OBJECTIVE
The objective of this study was to evaluate head and neck masses with real-time elastography to differentiate malignant masses.


METHODS
Between January 2011 and December 2012, a total of 51 patients with a palpable mass in the neck region were included in this study. Excisional histopathologic data were compared with elastographic results and Doppler ultrasonography.


RESULTS
The study group comprised 27 males (52.9%) and 24 females (47.1%) (mean [SD] age, 41.47 [19.59] y; range, 4-80 y). Fourteen masses were malignant (27.5%) and 37 were benign (72.5%). Comparing the elastographic results of benign and malignant masses, elastographic scores of the malignant masses were significantly higher than those of the benign masses (P < 0.005).The elastographic scores were divided into 2 groups: 34 (91.9%) patients with the diagnosis of benign mass had the score of 1 to 2, whereas 9 (64.3%) patients with the diagnosis of malignant cases had the score of 3 to 4. There was a significant difference between the groups (P < 0.005).However, 2 squamous cell carcinomas (28.6%) and 1 lymphoma (8.1%) were diagnosed with an elastographic score of 1 (Table 2). This showed that even an elastographic score of 1 was not enough to issue a diagnosis of benign masses.


CONCLUSIONS
With improvements in the device and increased experience, this modality can become a useful tool for the routine use. However, this modality cannot be used for screening to merely provide additional information about the nature of the masses.
From the Departments of *Otorhinolaryngology-Head and Neck Surgery, and †Radiology, Okmeydani Training and Research Hospital, Istanbul, Turkey.
Tolgar Lütfi
TL
Kumral
Güven
G
Yildirim
Suzan Deniz
SD
Önol
Enes
E
Ataç
Yavuz
Y
Uyar
Zafer Ünsal
ZÜ
Coşkun
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000379:methods*; D004724:Endoscopy / Q000379:methods; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D007828:Laryngoscopy; D008223:Lymphoma / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012468:Salivary Gland Neoplasms / Q000000981:diagnostic imaging; D018608:Ultrasonography, Doppler; D055815:Young Adult