title: Retrospective Assessment of the Utility of Imaging, Fine-Needle Aspiration Biopsy, and Intraoperative Frozen Section in the Management of Parotid Neoplasms: The Weill Cornell Medical College Experience.
abstract: OBJECTIVE
  Preoperative identification of malignant parotid lesions remains challenging, and thus, some surgeons use frozen section (FS) to assist them in their decision making. We evaluated the pathologic and cost benefit of FS after fine-needle aspiration (FNA) at our institution.
  
  
  METHODS
  We assessed medical data for 260 patients undergoing parotidectomy with FS. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were calculated for radiology, FNA, and FS.
  
  
  RESULTS
  The sensitivities, specificities, and accuracies of FNA and FS were 75.0, 96.4, and 93.2%, and 75.0, 100, and 96.8%, respectively. FS detected 0% of FNA false negatives and 80% of false positives. The additional pathology charge for FS alone per correctly identified benign lesion after a positive FNA was USD 1,443.
  
  
  CONCLUSIONS
  FNA and FS are more reliable in the prognostication of the final pathology than radiology. At our center, FS appears to be of limited clinical use after benign FNAs, but may be more useful after positive, indeterminate, and nondiagnostic FNAs.
authors.affiliation: Weill Cornell Medical College, New York, N.Y., USA.
authors.forename: Krupa R
authors.initials: KR
authors.lastname: Patel
authors.forename: Theresa
authors.initials: T
authors.lastname: Scognamiglio
authors.forename: David I
authors.initials: DI
authors.lastname: Kutler
authors.forename: William I
authors.initials: WI
authors.lastname: Kuhel
authors.forename: Jonathan
authors.initials: J
authors.lastname: Gromis
authors.forename: C Douglas
authors.initials: CD
authors.lastname: Phillips
authors.forename: Marc A
authors.initials: MA
authors.lastname: Cohen
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D002277:Carcinoma / Q000175:diagnosis* / Q000601:surgery; D002648:Child; D005260:Female; D005629:Frozen Sections; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010307:Parotid Neoplasms / Q000175:diagnosis* / Q000601:surgery; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult