Skip to main content
Top
Published in: European Radiology 7/2018

01-07-2018 | Head and Neck

Accuracy and effectiveness of ultrasound-guided core-needle biopsy in the diagnosis of focal lesions in the salivary glands

Published in: European Radiology | Issue 7/2018

Login to get access

Abstract

Objectives

To review the diagnostic accuracy of ultrasound-guided core-needle biopsy (CNB) in the diagnosis of salivary gland tumours (SGT).

Methods

Retrospective, institutional review board approved, analysis of the CNB of SGT performed at our centre in 8 years. We used an automatic 18-G spring-loaded device. The final diagnosis was based on surgery in the cases that were operated on, and on clinical evolution and biopsy findings in the rest.

Results

Four hundred and nine biopsies were performed in 381 patients (ages, 2-97 years; mean, 55.9). There were two minor complications. Biopsy was diagnostic in 98.3%. There were eight false negatives. The diagnostic values for malignancy were: sensitivity 89.6%, specificity 100%, positive predictive value (PPV) 100% and negative predictive value (NPV) 98%. For the detection of neoplasms were: sensitivity 98.7%, specificity 99%, PPV 99.7% and VPN 96.1%.

Conclusions

Accuracy of CNB in SGT is very high, with a very high sensitivity and an absolutely reliable diagnosis of malignancy. Complication rate is very low. It should be considered the technique of choice when a STG is detected. Normal tissue results warrant repeating biopsy.

Key Points

• Ultrasound-guided core-biopsy is the technique of choice in salivary glands nodules
• Sensitivity, specificity for detecting neoplasms (which should be resected) are around 99%
• Diagnosis of malignancy in core-biopsy is absolutely reliable
• A CNB result of “normal tissue”, however, warrants repeating the biopsy
• Complication rate is very low
Appendix
Available only for authorised users
Literature
1.
go back to reference Bialek EJ, Jakubowski W, Zajkowski P, Kazimerez T, Osmolski A (2006) US of the major salivary glands : anatomy and spatial relationships, pathologic conditions, and pitfalls 1. Radiographics 26:745–764CrossRefPubMed Bialek EJ, Jakubowski W, Zajkowski P, Kazimerez T, Osmolski A (2006) US of the major salivary glands : anatomy and spatial relationships, pathologic conditions, and pitfalls 1. Radiographics 26:745–764CrossRefPubMed
2.
go back to reference Learned KO, Lev-Toaff AS, Brake BJ, Wu RI, Langer JE, Loevner LA (2016) US-guided biopsy of neck lesions: the head and neck neuroradiologist’s perspective. Radiographics 36:226–243CrossRefPubMed Learned KO, Lev-Toaff AS, Brake BJ, Wu RI, Langer JE, Loevner LA (2016) US-guided biopsy of neck lesions: the head and neck neuroradiologist’s perspective. Radiographics 36:226–243CrossRefPubMed
3.
go back to reference Wu S, Liu G, Chen R, Guan Y (2012) Role of ultrasound in the assessment of benignity and malignancy of parotid masses. Dentomaxillofacial Radiol 41:131–135CrossRef Wu S, Liu G, Chen R, Guan Y (2012) Role of ultrasound in the assessment of benignity and malignancy of parotid masses. Dentomaxillofacial Radiol 41:131–135CrossRef
4.
go back to reference Pinkston J, Cole P (1999) Incidence rates of salivary gland tumors: results from a population-based study. Otolaryngol Head Neck Surg 120:834–840CrossRefPubMed Pinkston J, Cole P (1999) Incidence rates of salivary gland tumors: results from a population-based study. Otolaryngol Head Neck Surg 120:834–840CrossRefPubMed
6.
go back to reference Liu Y, Li J, Tan YR, Xiong P, Zhong LP (2015) Accuracy of diagnosis of salivary gland tumors with the use of ultrasonography, computed tomography, and magnetic resonance imaging: a meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 119:238–245.e2CrossRefPubMed Liu Y, Li J, Tan YR, Xiong P, Zhong LP (2015) Accuracy of diagnosis of salivary gland tumors with the use of ultrasonography, computed tomography, and magnetic resonance imaging: a meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 119:238–245.e2CrossRefPubMed
7.
go back to reference Jin GQ, Su DK, Xie D, Zhao W, Liu LD, Zhu XN (2011) Distinguishing benign from malignant parotid gland tumours: low-dose multi-phasic CT protocol with 5-minute delay. Eur Radiol 21:1692–1698CrossRefPubMedPubMedCentral Jin GQ, Su DK, Xie D, Zhao W, Liu LD, Zhu XN (2011) Distinguishing benign from malignant parotid gland tumours: low-dose multi-phasic CT protocol with 5-minute delay. Eur Radiol 21:1692–1698CrossRefPubMedPubMedCentral
8.
go back to reference Lechner-Goyault J, Riehm S, Neuville A, Gentine A, Veillon F (2011) Interest of diffusion-weighted and gadolinium-enhanced dynamic MR sequences for the diagnosis of parotid gland tumors. J Neuroradiol 38:77–89CrossRefPubMed Lechner-Goyault J, Riehm S, Neuville A, Gentine A, Veillon F (2011) Interest of diffusion-weighted and gadolinium-enhanced dynamic MR sequences for the diagnosis of parotid gland tumors. J Neuroradiol 38:77–89CrossRefPubMed
9.
11.
go back to reference 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 39:349–355CrossRef 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 39:349–355CrossRef
12.
go back to reference Song IH, Song JS, Sung CO et al (2015) Accuracy of core needle biopsy versus fine needle aspiration cytology for diagnosing salivary gland tumors. J Pathol Transl Med 49:136–143CrossRefPubMedPubMedCentral Song IH, Song JS, Sung CO et al (2015) Accuracy of core needle biopsy versus fine needle aspiration cytology for diagnosing salivary gland tumors. J Pathol Transl Med 49:136–143CrossRefPubMedPubMedCentral
13.
go back to reference Gudmundsson JK, Ajan A, Abtahi J (2016) The accuracy of fine-needle aspiration cytology for diagnosis of parotid gland masses: a clinicopathological study of 114 patients. J Appl Oral Sci 24:561–567CrossRefPubMedPubMedCentral Gudmundsson JK, Ajan A, Abtahi J (2016) The accuracy of fine-needle aspiration cytology for diagnosis of parotid gland masses: a clinicopathological study of 114 patients. J Appl Oral Sci 24:561–567CrossRefPubMedPubMedCentral
14.
go back to reference Sood S, McGurk M, Vaz F (2016) Management of salivary gland tumours: United Kingdom national multidisciplinary guidelines. J Laryngol Otol 130:S142–S149CrossRefPubMedPubMedCentral Sood S, McGurk M, Vaz F (2016) Management of salivary gland tumours: United Kingdom national multidisciplinary guidelines. J Laryngol Otol 130:S142–S149CrossRefPubMedPubMedCentral
15.
16.
go back to reference Bajwa MS, Rose SJ, Mairembam P (2016) Feasibility of a novel classification for parotid gland cytology: a retrospective review of 512 cytology reports taken from 4 United Kingdom general hospitals. Head Neck 38:1596–1603CrossRefPubMed Bajwa MS, Rose SJ, Mairembam P (2016) Feasibility of a novel classification for parotid gland cytology: a retrospective review of 512 cytology reports taken from 4 United Kingdom general hospitals. Head Neck 38:1596–1603CrossRefPubMed
17.
go back to reference Sharma G, Jung AS, Maceri DR, Rice DH, Martin SE, Grant EG (2011) US-guided fine-needle aspiration of major salivary gland masses and adjacent lymph nodes: accuracy and impact on clinical decision making. Radiology 259:471–478CrossRefPubMed Sharma G, Jung AS, Maceri DR, Rice DH, Martin SE, Grant EG (2011) US-guided fine-needle aspiration of major salivary gland masses and adjacent lymph nodes: accuracy and impact on clinical decision making. Radiology 259:471–478CrossRefPubMed
18.
go back to reference Cho HW, Kim J, Choi J et al (2011) Sonographically guided fine-needle aspiration biopsy of major salivary gland masses: a review of 245 cases. AJR Am J Roentgenol 196:1160–1163CrossRefPubMed Cho HW, Kim J, Choi J et al (2011) Sonographically guided fine-needle aspiration biopsy of major salivary gland masses: a review of 245 cases. AJR Am J Roentgenol 196:1160–1163CrossRefPubMed
19.
go back to reference Balakrishnan K, Castling B, McMahon J et al (2005) Fine needle aspiration cytology in the management of a parotid mass: a two centre retrospective study. Surgeon 3:67–72CrossRefPubMed Balakrishnan K, Castling B, McMahon J et al (2005) Fine needle aspiration cytology in the management of a parotid mass: a two centre retrospective study. Surgeon 3:67–72CrossRefPubMed
20.
go back to reference Fakhry N, Antonini F, Michel J et al (2012) Fine-needle aspiration cytology in the management of parotid masses: evaluation of 249 patients. Eur Ann Otorhinolaryngol Head Neck Dis 129:131–135CrossRefPubMed Fakhry N, Antonini F, Michel J et al (2012) Fine-needle aspiration cytology in the management of parotid masses: evaluation of 249 patients. Eur Ann Otorhinolaryngol Head Neck Dis 129:131–135CrossRefPubMed
21.
go back to reference Haldar S, Mandalia U, Skelton E et al (2015) Diagnostic investigation of parotid neoplasms: a 16-year experience of freehand fine needle aspiration cytology and ultrasound-guided core needle biopsy. Int J Oral Maxillofac Surg 44:151–157CrossRefPubMed Haldar S, Mandalia U, Skelton E et al (2015) Diagnostic investigation of parotid neoplasms: a 16-year experience of freehand fine needle aspiration cytology and ultrasound-guided core needle biopsy. Int J Oral Maxillofac Surg 44:151–157CrossRefPubMed
22.
go back to reference Consamus EN, Smith D, Pina Oviedo S, Mody DR, Takei H (2015) Diagnostic accuracy of fine-needle aspiration cytology of salivary gland lesions: a 6-year retrospective review. J Am Soc Cytopathol 4:63–73CrossRefPubMed Consamus EN, Smith D, Pina Oviedo S, Mody DR, Takei H (2015) Diagnostic accuracy of fine-needle aspiration cytology of salivary gland lesions: a 6-year retrospective review. J Am Soc Cytopathol 4:63–73CrossRefPubMed
23.
go back to reference Bajwa J, Christodoulou D, Howlett DC (2012) Biopsy of major salivary gland masses. AJR Am J Roentgenol 198:2012CrossRef Bajwa J, Christodoulou D, Howlett DC (2012) Biopsy of major salivary gland masses. AJR Am J Roentgenol 198:2012CrossRef
24.
go back to reference Howlett DC, Menezes LJ, Lewis K, Moody AB, Violaris N, Williams MD (2007) Sonographically guided core biopsy of a parotid mass. AJR Am J Roentgenol 188:223–227CrossRefPubMed Howlett DC, Menezes LJ, Lewis K, Moody AB, Violaris N, Williams MD (2007) Sonographically guided core biopsy of a parotid mass. AJR Am J Roentgenol 188:223–227CrossRefPubMed
25.
go back to reference Witt BL, Schmidt RL (2014) Ultrasound-guided core needle biopsy of salivary gland lesions: a systematic review and meta-analysis. Laryngoscope 124:695–700CrossRefPubMed Witt BL, Schmidt RL (2014) Ultrasound-guided core needle biopsy of salivary gland lesions: a systematic review and meta-analysis. Laryngoscope 124:695–700CrossRefPubMed
26.
go back to reference Pfeiffer J, Ridder GJ (2012) Diagnostic value of ultrasound-guided core needle biopsy in patients with salivary gland masses. Int J Oral Maxillofac Surg 41:437–443CrossRefPubMed Pfeiffer J, Ridder GJ (2012) Diagnostic value of ultrasound-guided core needle biopsy in patients with salivary gland masses. Int J Oral Maxillofac Surg 41:437–443CrossRefPubMed
27.
go back to reference Novoa E, Gurtler N, Arnoux A, Kraft M (2012) Role of ultrasound-guided core-needle biopsy in the assessment of head and neck lesions: a meta-analysis and systematic review of the literature. Head Neck 34:1497–1503CrossRefPubMed Novoa E, Gurtler N, Arnoux A, Kraft M (2012) Role of ultrasound-guided core-needle biopsy in the assessment of head and neck lesions: a meta-analysis and systematic review of the literature. Head Neck 34:1497–1503CrossRefPubMed
28.
go back to reference Schmidt RL, Hall BJ, Wilson ARLL (2011) A systematic review and meta-analysis of the diagnostic accuracy of fine- needle aspiration cytology for parotid gland lesions. Am J Clin Pathol 136:45–59CrossRefPubMed Schmidt RL, Hall BJ, Wilson ARLL (2011) A systematic review and meta-analysis of the diagnostic accuracy of fine- needle aspiration cytology for parotid gland lesions. Am J Clin Pathol 136:45–59CrossRefPubMed
29.
go back to reference Eom HJ, Lee JH, Ko MS et al (2015) Comparison of fine-needle aspiration and core needle biopsy under ultrasonographic guidance for detecting malignancy and for the tissue-specific diagnosis of salivary gland tumors. AJNR Am J Neuroradiol 36:1188–1193CrossRefPubMedPubMedCentral Eom HJ, Lee JH, Ko MS et al (2015) Comparison of fine-needle aspiration and core needle biopsy under ultrasonographic guidance for detecting malignancy and for the tissue-specific diagnosis of salivary gland tumors. AJNR Am J Neuroradiol 36:1188–1193CrossRefPubMedPubMedCentral
30.
go back to reference Douville NJ, Bradfor CR (2013) Comparison of ultrasound-guided core biopsy versus fine-needle aspiration biopsy in the evaluation of salivary gland lesions. Head Neck 35:1657–1661CrossRefPubMed Douville NJ, Bradfor CR (2013) Comparison of ultrasound-guided core biopsy versus fine-needle aspiration biopsy in the evaluation of salivary gland lesions. Head Neck 35:1657–1661CrossRefPubMed
Metadata
Title
Accuracy and effectiveness of ultrasound-guided core-needle biopsy in the diagnosis of focal lesions in the salivary glands
Publication date
01-07-2018
Published in
European Radiology / Issue 7/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5295-9

Other articles of this Issue 7/2018

European Radiology 7/2018 Go to the issue