Top

Published in:

01-02-2018 | COMPUTED TOMOGRAPHY

Assessment of salivary gland tumors using MRI and CT: impact of experience on diagnostic accuracy

Authors: Thomas J. Vogl, Moritz H. Albrecht, Nour-El-din A. Nour-Eldin, Hanns Ackermann, Adel Maataoui, Timo Stöver, Matthew W. Bickford, Tatjana Stark-Paulsen

Published in: La radiologia medica | Issue 2/2018

Abstract

Rationale and objectives

To analyze the accuracy of radiological diagnosis in MRI and CT studies of salivary gland tumors depending on the radiologist’s experience.

Materials and methods

Three radiologists with differing experience (R1 > 20, R2 > 11, and R3 > 7 years, respectively) retrospectively reviewed 128 cases (116 MRI, 12 CT studies) with suspected salivary gland tumors regarding dignity and classification using histopathology as a reference standard. Sensitivity, specificity, positive/negative predictive value and inter-observer agreement (using Cohen’s κ) were calculated to compare diagnostic performance.

Results

Lesions were benign in 87 and in 23 cases malignant. Neoplasia was absent in 18 cases (15 cases without neoplasia and 3 cases without disease). The highest inter-observer agreement for determining dignity using CT was found between R1 and R2 (κ = 0.74, p < 0.001), and the lowest between R2 and R3 (κ = 0.28, p < 0.001). MRI sensitivity/specificity for classifying pleomorphic adenomas was as follows: R1 (100%/100%), R2 (76.92%/87.01%), R3 (43.53%/67.53%), and for CT: R1 (100%/100%), R2 (100%/88.89%), R3 (66.67%/88.89%; for Warthin’s tumor using MRI: R1 (100%/97.44%), R2 (68.42%/83.33%), R3 (50.00%/67.95%), and using CT: R1 (100%/100%), R2 (50.00%/100%), R3 (100%/100%; for squamous cell carcinomas using MRI: R1 (100%/100%), R2 (75.00%/97.12%), R3 (75.00%/99.04%), and using CT: R1 (100%/100%), R2 (66.67%/88.89%), R3 (66.67%/66.67%). The highest agreement was found between R1 and R2 for MRI (κ = 0.62, p < 0.001), and the lowest between R1 and R3 at MRI (κ = 0.28, p < 0.001).

Conclusion

Diagnostic accuracy in the assessment of salivary gland tumors strongly depends on the observer’s expertise and increases with higher experience.

Bello IO, Salo T, Dayan D, Tervahauta E, Almangoush A, Schnaiderman-Shapiro A, Barshack I, Leivo I, Vered M (2012) Epithelial salivary gland tumors in two distant geographical locations, Finland (Helsinki and Oulu) and Israel (Tel Aviv): a 10-year retrospective comparative study of 2218 cases. Head Neck Pathol 6:224–231. doi:10.1007/s12105-011-0316-5 CrossRefPubMedPubMedCentral

Bisdas S, Baghi M, Wagenblast J, Knecht R, Thng CH, Koh TS, Vogl TJ (2007) Differentiation of benign and malignant parotid tumors using deconvolution-based perfusion CT imaging: feasibility of the method and initial results. Eur J Radiol 64:258–265. doi:10.1016/j.ejrad.2007.02.032 CrossRefPubMed

Bjørndal K, Krogdahl A, Therkildsen MH, Overgaard J, Johansen J, Kristensen CA, Homøe P, Sørensen CH, Andersen E, Bundgaard T, Primdahl H, Lambertsen K, Andersen LJ, Godballe C (2011) Salivary gland carcinoma in Denmark 1990–2005: a national study of incidence, site and histology. Results of the Danish Head and Neck Cancer Group (DAHANCA). Oral Oncol 47:677–682. doi:10.1016/j.oraloncology.2011.04.020 CrossRefPubMed

Bradley PJ, McGurk M (2013) Incidence of salivary gland neoplasms in a defined UK population. Br J Oral Maxillofac Surg 51:399–403. doi:10.1016/j.bjoms.2012.10.002 CrossRefPubMed

Burke CJ, Thomas RH, Howlett D (2011) Imaging the major salivary glands. Br J Oral Maxillofac Surg 49:261–269. doi:10.1016/j.bjoms.2010.03.002 CrossRefPubMed

Cardello P, Trinci M, Messineo D, Tuccimei M, Massa R, Marini M, Trinci M (1998) Diagnostic imaging of the salivary glands in patients undergoing radiotherapy of head and neck neoplasms. Radiol Med (Torino) 95:224–231

Christe A, Waldherr C, Hallett R, Zbaeren P, Thoeny H (2011) MR imaging of parotid tumors: typical lesion characteristics in MR imaging improve discrimination between benign and malignant disease. Am J Neuroradiol 32:1202–1207. doi:10.3174/ajnr.A2520 CrossRefPubMed

Davachi B, Imanimoghaddam M, Majidi MR, Sahebalam A, Johari M, Javadian Langaroodi A, Shakeri MT (2014) The efficacy of magnetic resonance imaging and color doppler ultrasonography in diagnosis of salivary gland tumors. J Dent Res Dent Clin Dent Prospects 8:246–251. doi:10.5681/joddd.2014.044 PubMedPubMedCentral

de Ridder M, Balm AJM, Smeele LE, Wouters MWJM, van Dijk BAC (2015) An epidemiological evaluation of salivary gland cancer in the Netherlands (1989–2010). Cancer Epidemiol 39:14–20. doi:10.1016/j.canep.2014.10.007 CrossRefPubMed

10.

Espinoza S, Felter A, Malinvaud D, Badoual C, Chatellier G, Siauve N, Halimi P (2014) Warthin’s tumor of parotid gland: surgery or follow-up? Diagnostic value of a decisional algorithm with functional MRI. Diagn Interv Imaging. doi:10.1016/j.diii.2014.11.024 PubMed

11.

Fakhry N, Aldosari B, Michel J, Giorgi R, Collet C, Santini L, Giovanni A, Dessi P (2013) Clinical and oncological outcomes after surgical excision of parotid gland tumours in patients aged over 80 years. Int J Oral Maxillofac Surg 42:1385–1390. doi:10.1016/j.ijom.2013.06.010 CrossRefPubMed

12.

Fernandes H, D’souza CRS, Khosla C, George L, Katte NH (2014) Role of FNAC in the preoperative diagnosis of salivary gland lesions. J Clin Diagn Res JCDR 8:FC01–FC03. doi:10.7860/JCDR/2014/6735.4809 PubMed

13.

Fonseca FP, de Vasconcelos Carvalho M, de Almeida OP, Rangel ALCA, Takizawa MCH, Bueno AG, Vargas PA (2012) Clinicopathologic analysis of 493 cases of salivary gland tumors in a Southern Brazilian population. Oral Surg Oral Med Oral Pathol Oral Radiol 114:230–239. doi:10.1016/j.oooo.2012.04.008 CrossRefPubMed

14.

Fritz AG (2013) International classification of diseases for oncology: ICD-O, third edition, first revision. World Health Organization, Geneva

15.

Ho K, Lin H, Ann DK, Chu PG, Yen Y (2011) An overview of the rare parotid gland cancer. Head Neck Oncol 3:40. doi:10.1186/1758-3284-3-40 CrossRefPubMedPubMedCentral

16.

Joe VQ, Westesson PL (1994) Tumors of the parotid gland: MR imaging characteristics of various histologic types. Am J Roentgenol 163:433–438. doi:10.2214/ajr.163.2.8037045 CrossRef

17.

Kafi MAH, Bhuyan MAH, Bhuiyan MJH, Alam MK (2010) Management of salivary gland neoplasm—study of 32 cases. Bangladesh J Med Sci 9:87–94. doi:10.3329/bjms.v9i2.5656 CrossRef

18.

Kato H, Kanematsu M, Makita H, Kato K, Hatakeyama D, Shibata T, Mizuta K, Aoki M (2014) CT and MR imaging findings of palatal tumors. Eur J Radiol 83:e137–e146. doi:10.1016/j.ejrad.2013.11.028 CrossRefPubMed

19.

Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174. doi:10.2307/2529310 CrossRefPubMed

20.

Lee YYP, Wong KT, King AD, Ahuja AT (2008) Imaging of salivary gland tumours. Eur J Radiol 66:419–436. doi:10.1016/j.ejrad.2008.01.027 CrossRefPubMed

21.

Liu Y, Li K, Shi H, Tao X (2014) Solitary fibrous tumours in the extracranial head and neck region: correlation of CT and MR features with pathologic findings. Radiol Med (Torino) 119:910–919. doi:10.1007/s11547-014-0409-9 CrossRef

22.

Louie KS, Mehanna H, Sasieni P (2015) Trends in head and neck cancers in England from 1995 to 2011 and projections up to 2025. Oral Oncol. doi:10.1016/j.oraloncology.2015.01.002 PubMed

23.

Mack MG, Vogl TJ (1999) MR imaging of the head and neck. Eur Radiol 9:1247–1251. doi:10.1007/s003300050830 CrossRefPubMed

24.

Mazziotti S, Blandino A, Gaeta M, Bottari A, Sofia C, D’Angelo T, Ascenti G (2015) Postprocessing in maxillofacial multidetector computed tomography. Can Assoc Radiol J 66:212–222. doi:10.1016/j.carj.2014.12.004 CrossRefPubMed

25.

Mazziotti S, Pandolfo I, D’Angelo T, Mileto A, Visalli C, Racchiusa S, Blandino A, Ascenti G (2014) Diagnostic approach to retromolar trigone cancer by multiplanar computed tomography reconstructions. Can Assoc Radiol J 65:335–344. doi:10.1016/j.carj.2014.04.001 CrossRefPubMed

26.

Nagarkar NM, Bansal S, Dass A, Singhal SK, Mohan H (2004) Salivary gland tumors—our experience. Indian J Otolaryngol Head Neck Surg 56:31–34. doi:10.1007/BF02968769 PubMedPubMedCentral

27.

Noij DP, Martens RM, Marcus JT, de Bree R, Leemans CR, Castelijns JA, de Jong MC, de Graaf P (2017) Intravoxel incoherent motion magnetic resonance imaging in head and neck cancer: a systematic review of the diagnostic and prognostic value. Oral Oncol 68:81–91. doi:10.1016/j.oraloncology.2017.03.016 CrossRefPubMed

28.

Parkins G, Boamah MO (2009) Tumours of the salivary gland in Ghana. Asian J Oral Maxillofac Surg 21:96–100. doi:10.1016/S0915-6992(09)80004-6 CrossRef

29.

Raine C, Saliba K, Chippindale AJ, McLean NR (2003) Radiological imaging in primary parotid malignancy. Br J Plast Surg 56:637–643. doi:10.1016/S0007-1226(03)00358-8 CrossRefPubMed

30.

Rudack C, Jörg S, Kloska S, Stoll W, Thiede O (2007) Neither MRI, CT nor US is superior to diagnose tumors in the salivary glands— an extended case study. Head Face Med 3:19. doi:10.1186/1746-160X-3-19 CrossRefPubMedPubMedCentral

31.

Shishegar M, Ashraf MJ, Azarpira N, Khademi B, Hashemi B, Ashrafi A (2011) Salivary gland tumors in maxillofacial region: a retrospective study of 130 cases in a Southern Iranian population. Pathol Res Int 2011:1–5. doi:10.4061/2011/934350 CrossRef

32.

Speight P, Barrett A (2002) Salivary gland tumours. Oral Dis 8:229–240. doi:10.1034/j.1601-0825.2002.02870.x CrossRefPubMed

33.

Subhashraj K (2008) Salivary gland tumors: a single institution experience in India. Br J Oral Maxillofac Surg 46:635–638. doi:10.1016/j.bjoms.2008.03.020 CrossRefPubMed

34.

Torabinia N, Khalesi S (2014) Clinicopathological study of 229 cases of salivary gland tumors in Isfahan population. Dent Res J 11:559–563

35.

Vogl TJ (2010) Different imaging techniques in the head and neck: assets and drawbacks. World J Radiol 2:224. doi:10.4329/wjr.v2.i6.224 CrossRefPubMedPubMedCentral

36.

Vogl TJ, Dresel SH, Späth M, Grevers G, Wilimzig C, Schedel HK, Lissner J (1990) Parotid gland: plain and gadolinium-enhanced MR imaging. Radiology 177:667–674. doi:10.1148/radiology.177.3.2243966 CrossRefPubMed

37.

Wang Y-L, Zhu Y-X, Chen T-Z, Wang Y, Sun G-H, Zhang L, Huang C-P, Wang Z-Y, Shen Q, Li D-S, Wu Y, Ji Q-H (2012) Clinicopathologic study of 1176 salivary gland tumors in a Chinese population: experience of one cancer center 1997–2007. Acta Otolaryngol (Stockh) 132:879–886. doi:10.3109/00016489.2012.662715 CrossRef

38.

Xu Z-F (2013) Different histological subtypes of parotid gland tumors: CT findings and diagnostic strategy. World J Radiol 5:313. doi:10.4329/wjr.v5.i8.313 CrossRefPubMedPubMedCentral

39.

Yerli H, Aydin E, Haberal N, Harman A, Kaskati T, Alibek S (2010) Diagnosing common parotid tumours with magnetic resonance imaging including diffusion-weighted imaging vs fine-needle aspiration cytology: a comparative study. Dentomaxillofacial Radiol 39:349–355. doi:10.1259/dmfr/15047967 CrossRef

Title: Assessment of salivary gland tumors using MRI and CT: impact of experience on diagnostic accuracy
Authors: Thomas J. Vogl
Moritz H. Albrecht
Nour-El-din A. Nour-Eldin
Hanns Ackermann
Adel Maataoui
Timo Stöver
Matthew W. Bickford
Tatjana Stark-Paulsen
Publication date: 01-02-2018
Publisher: Springer Milan
Published in: La radiologia medica / Issue 2/2018
Print ISSN: 0033-8362
Electronic ISSN: 1826-6983
DOI: https://doi.org/10.1007/s11547-017-0813-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Assessment of salivary gland tumors using MRI and CT: impact of experience on diagnostic accuracy

Abstract

Rationale and objectives

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Rationale and objectives

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 2/2018

Feasibility of intraoral ultrasonography in the diagnosis of oral soft tissue lesions: a preclinical assessment on an ex vivo specimen

Effects of serial macrocyclic-based contrast materials gadoterate meglumine and gadobutrol administrations on gadolinium-related dentate nuclei signal increases in unenhanced T1-weighted brain: a retrospective study in 158 multiple sclerosis (MS) patients

Analysis of histological findings obtained combining US/mp-MRI fusion-guided biopsies with systematic US biopsies: mp-MRI role in prostate cancer detection and false negative

Correlation of abdominopelvic computed tomography with clinical manifestations in methamphetamine body stuffers

Percutaneous treatment of hepatic cystic echinococcosis: the success of alcohol as a single endocavitary agent in PAIR, catheterization, and modified catheterization techniques

Application of a full model-based iterative reconstruction (MBIR) in 80 kVp ultra-low-dose paranasal sinus CT imaging of pediatric patients