title: Initial Experience With Ultrasound Elastography for Diagnosis of Major Salivary Gland Lesions.
abstract: OBJECTIVE
  The aim of this study was to evaluate the usefulness of ultrasound elastography, including conventional strain elastography, acoustic radiation force impulse (ARFI)-induced strain elastography, and point shear wave elastography (SWE) for diagnosis of major salivary gland lesions.
  
  
  METHODS
  Forty major salivary gland lesions underwent conventional sonography, conventional strain elastography, ARFI strain elastography, and point SWE before surgery or biopsy. The diagnostic performances of the sonographic and elastographic techniques were assessed with reference to histopathologic results.
  
  
  RESULTS
  There were 32 benign (7 Warthin tumors, 17 pleomorphic adenomas, and 8 other benign lesions) and 8 malignant (1 squamous carcinoma, 2 metastases, 2 mucoepidermoid carcinomas, 1 anaplastic carcinoma, and 2 malignant lymphomas) major salivary gland lesions on pathologic analysis. No conventional sonographic features or conventional strain elastographic scores were found to be associated with malignancy (all P > .05). The ARFI strain elastographic scores between benign and malignant lesions were statistically different (P = .032) and an ARFI strain elastographic score of 4 or greater was highly predictive of malignancy (P= .025). An ARFI strain elastographic score of greater than 3 achieved specificity of 81.3% (26 of 32) and sensitivity of 62.5% (5 of 8) in differentiating benign from malignant lesions. The shear wave velocity on point SWE did not show a significant difference in distinguishing between malignant and benign lesions (6.07 versus 4.43 m/s; P > .05). However, Warthin tumors had a trend to show lower shear wave velocities compared with pleomorphic adenomas (2.84 versus 5.27 m/s; P = .024).
  
  
  CONCLUSIONS
  Acoustic radiation force impulse strain elastography may be potentially useful for diagnosing major salivary gland lesions, whereas conventional strain elastography and point SWE are not helpful.
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai Center for Thyroid Diseases, Shanghai, China.|In-Patient Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China.|Thyroid Institute, Tongji University School of Medicine, Shanghai, China.
authors.forename: Hang
authors.initials: H
authors.lastname: Zhou
authors.affiliation: In-Patient Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China.
authors.forename: Xian-Li
authors.initials: XL
authors.lastname: Zhou
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai Center for Thyroid Diseases, Shanghai, China xuhuixiong@hotmail.com.|Thyroid Institute, Tongji University School of Medicine, Shanghai, China. xuhuixiong@hotmail.com.
authors.forename: Hui-Xiong
authors.initials: HX
authors.lastname: Xu
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai Center for Thyroid Diseases, Shanghai, China.|Thyroid Institute, Tongji University School of Medicine, Shanghai, China.
authors.forename: Ya-Ping
authors.initials: YP
authors.lastname: He
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai Center for Thyroid Diseases, Shanghai, China.|Thyroid Institute, Tongji University School of Medicine, Shanghai, China.
authors.forename: Xiao-Wan
authors.initials: XW
authors.lastname: Bo
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai Center for Thyroid Diseases, Shanghai, China.|Thyroid Institute, Tongji University School of Medicine, Shanghai, China.
authors.forename: Xiao-Long
authors.initials: XL
authors.lastname: Li
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai Center for Thyroid Diseases, Shanghai, China.|Thyroid Institute, Tongji University School of Medicine, Shanghai, China.
authors.forename: Bo-Ji
authors.initials: BJ
authors.lastname: Liu
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai Center for Thyroid Diseases, Shanghai, China.|Thyroid Institute, Tongji University School of Medicine, Shanghai, China.
authors.forename: Dan-Dan
authors.initials: DD
authors.lastname: Li
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai Center for Thyroid Diseases, Shanghai, China.|Thyroid Institute, Tongji University School of Medicine, Shanghai, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012468:Salivary Gland Neoplasms / Q000000981:diagnostic imaging*; D012469:Salivary Glands / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity
keywords: acoustic radiation force impulse; diagnosis; head and neck ultrasound; salivary gland neoplasm; strain elastography