Dana Ioana Dumitriu MD, Presenter: Nothing to Disclose

Sorin Marian Dudea MD, PhD, Abstract Co-Author: Nothing to Disclose

Carolina Botar-Jid MD, Abstract Co-Author: Nothing to Disclose

Elastography is increasingly used in diagnosing tumors of the breast, thyroid gland or prostate. The aim of this ongoing study is to assess whether or not elastography is helpful in increasing the diagnostic specificity of imaging in salivary gland tumors, since it has been proven that 2D and Doppler US, CT and even MRI are not very specific in this pathology.

Over the course of the last year, 23 patients with a total of 25 salivary gland lesions were examined. All patients presented with enlargement of one or more salivary glands; 22 of these presented with enlargement of the parotid region and one with enlargement of the submandibular region. The examination of each patient included grey-scale and Doppler ultrasound, followed by the elastographic examination, using the same specific protocol, developed in our department, for each patient. The elastographic appearance of the tumor was correlated with the pathology report, after surgical excision of the lesion.

Most of the tumors in the study group were benign: pleomorphic adenomas (the most frequent salivary gland tumors) and Warthin tumors. The elastographic aspect for both of these tumors was most frequently that of lesions with heterogeneous elasticity, but never that of overall rigidity. The stiffest areas were located in the periphery of the tumor in pleomorphic adenomas. Warthin's tumors did not have any typical elastographic features in comparison to pleomorphic adenomas. Malignant tumors presented more extensive areas of increased tissue stiffness; extension of the stiffness beyond the grey-scale border of the tumor was noted in several cases, but it is yet unclear whether this might be considered a feature of malignancy, as in the case of breast cancer.

Overall, the elastographic appearance of salivary gland tumors does not seem to fit into a definite pattern, such as the ones already described for breast tumors. So far, it is unlikely that elastography might help in establishing the differential diagnosis between the various hystological types of salivary gland tumor. However, it may raise the suspicion of malignancy in cases where the 2D image is inconclusive or falsely reassuring.

Combining elastography with 2D and Doppler ultrasound might improve the specificity of imaging in salivary gland tumors; a correct pre-operative diagnosis helps determine the best surgical approach.

Dumitriu, D, Dudea, S, Botar-Jid, C, Ultrasound Elastography Features of Major Salivary Gland Tumors.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6017627.html