Prospective evaluation of Quasistatic Ultrasound Elastography (USE) compared with Baseline US for parotid gland lesions: preliminary results of elasticity contrast index (ECI) evaluation.
OBJECTIVE
To assess the diagnostic value of elasticity contrast index (ECI) elastography, in comparison with conventional ultrasound for the differentiation of benign and malignant parotid lesions.


METHODS
Sixty-three consecutive patients with parotid gland tumors, treated surgically at a single tertiary center were enrolled. Ultrasound evaluation consisted of B-mode, color-Doppler and quasistatic ultrasound elastography (USE), conducted with the ECI technique. For each lesion the echogenicity, margins, vascularization, and capsulation were considered to determine benign or malignant lesions. Histology was considered the gold standard.


RESULTS
Using conventional parameters, the observer suggested malignant lesions in 20 cases and benign lesions in 43 cases (accuracy: 61.8%). ECI>3.5 alone was the most accurate parameter (accuracy: 90.5%), with sensitivity of 93.7% and specificity of 89.4%. However, when combined with the other US criteria, no statistically significant diagnostic accuracy improvement was achieved.


CONCLUSIONS
Our results show that USE with ECI index measurement can help to discriminate preoperatively benign from malignant lesions, with the exception of pleomorphic adenoma which is stiff. We suggest that USE can be used as an additional tool to conventional US evaluation of salivary gland lesions.
Department of Radiology, Oncology, and Anatomy Pathology, Policlinico Umberto I, University Sapienza, Rome, Italy. vito.cantisani@uniroma1.it.
Vito
V
Cantisani
Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino", Messina, Italy.
Emanuele
E
David
Department of Sensory Organs, ENT Section, "Sapienza" University of Rome, Rome, Italy.
Armando
A
De Virgilio
Department of Radiology, King's College Hospital, Denmark Hill, London, UK.
Paul S
PS
Sidhu
Associazione dei Cavalieri Italiani Sovrano Militare Ordine di Malta; Poliambulatorio Roma Eur, Rome, Italy.
Hektor
H
Grazhdani
Department of Sensory Organs, ENT Section, "Sapienza" University of Rome, Rome, Italy.
Antonio
A
Greco
Department of Sensory Organs, ENT Section, "Sapienza" University of Rome, Rome, Italy.
Marco
M
De Vincentiis
Department of Molecular Medicine, Policlinico Umberto I, University Sapienza, Rome, Italy.
Alessandro
A
Corsi
Department of Radiology, Oncology, and Anatomy Pathology, Policlinico Umberto I, University Sapienza, Rome, Italy.
Flaminia
F
De Cristofaro
Department of Medicine and Health Sciences, University of Molise, Campobasso,Italy.
Luca
L
Brunese
University Hospital of Pavia, Pavia, Italy.
Fabrizio
F
Calliada
Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino", Messina, Italy.
Alfredo
A
Blandino
Department of Sensory Organs, ENT Section, "Sapienza" University of Rome, Rome, Italy.
Mario
M
Tombolini
Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino", Messina, Italy.
Giorgio
G
Ascenti
University of Padova , Department of Medicine, Padova, Italy.
Roberto
R
Stramare
Department of Radiology, Oncology, and Anatomy Pathology, Policlinico Umberto I, University Sapienza, Rome, Italy.
Marcello
M
Caratozzolo
Department of Radiology, Oncology, and Anatomy Pathology, Policlinico Umberto I, University Sapienza, Rome, Italy.
Ferdinando
F
D'Ambrosio
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010306:Parotid Gland / Q000000981:diagnostic imaging; D010307:Parotid Neoplasms / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods; D055815:Young Adult