Leon Jonathan Menezes BMBCH, Presenter: Nothing to Disclose

Khari Lewis MBBS, Abstract Co-Author: Nothing to Disclose

Michael D Williams MD, Abstract Co-Author: Nothing to Disclose

David C. Howlett MBBS, Abstract Co-Author: Nothing to Disclose

To report the accuracy of ultrasound guided core biopsy (USCB) in obtaining a diagnosis in patients presenting with lesions of the parotid gland, compared to final surgical pathological histology.

133 consecutive patients presenting with a parotid mass, were prospectively enrolled into this study between 1998 and 2005. A single operator performed a diagnostic ultrasound and USCB under local anaesthestic, using 18 or 20 gauge needles and a spring loaded biopsy gun with a mean of 2 passes per patient. Outcome measures were the sensitivity, specificity and predictive values of USCB compared with the surgical pathological diagnosis as the gold standard. Final diagnosis was established on the basis of adequate histology, surgical specimen and clinical follow up in the non surgical group.

All USCB specimens were considered satisfactory for evaluation. 35/133 (26%) had malignant lesions and 98/133 (74%) benign. 64/133 (48%) patients underwent surgical excision after USCB. There was complete agreement betwen USCB and the final histology in 62/64 (97%) patients. Two cases of mucoepidermoid and squamous cell carcinoma did not correlate, but management was unaffected. In differentiating benign from malignant lesions, USCB had a sensitivity of 100% and a specificity of 100%. USCB had a positive predictive value of 100% and a negative predictive value of 100% in diagnosing malignancy. There were no immediate complications of USCB and there has been no tumour seeding on follow up. 69/133 (52%) patients avoided surgery as a result of USCB.

USCB is an accurate technique for the evaluation of parotid gland lesions. It can be safely performed under local anaesthetic as an outpatient. It has potential advantages over fine needle aspiration, particularly in typing and grading carcinomas and lymphomas. The use of of USCB avoids intraoperative biopsy or unnecessary surgery.

Menezes, L, Lewis, K, Williams, M, Howlett, D, Ultrasound-guided Core Needle Biopsy of Parotid Gland Lesions: Results in a Series of 133 Patients.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4406660.html