Magnetic Resonance Imaging versus Fine Needle Aspiration Biopsy in the Differential Diagnosis of Neoplastic Parotid Gland Lesions

Year 2019, Volume: 9 Issue: 1, 38 - 43, 19.03.2019

Muammer Melih Şahin Melih Çayönü Deniz Sözmen Cılız Elvan Evrim Ünsal Tuna Ayşe Seçil Kayalı Dinç , Süleyman Boynueğri Fulya Eker Barut Bülent Sakman Adil Eryılmaz

Abstract

Objective:This research aims to compare fine needle aspiration biopsy (FNAB) with magnetic resonance imaging (MRI) in differentiating between neoplasms found within the parotid gland.

Methods: Using a retrospective methodology, records were reviewed from 74 cases who had surgery for a parotid neoplastic lesion between January 2013 and November 2018. 41 cases were men and 33 women, with a mean age of 51.3±12.8 years. In each instance, comparison was made between the eventual histopathological diagnosis and the results of evaluation by FNAB or MRI prior to surgery. The comparison looked at how the two methods influenced surgical choice, their ability to distinguish between malignant and benign lesions and power to predict histopathological subtype.

Results:57 cases (out of 74) represented benign lesions (77%), whilst 17 were malignant (23%). Superficial parotidectomy was carried out on 54, and total parotidectomy on 20 individuals. FNAB had sensitivity in the detection of malignancy of 73.3% with a specificity of 100%. The accuracy was 93.4%. MRI, on the other hand, had sensitivity in the detection of malignancy of 81.2% with a specificity of 90.5%. The accuracy was 88.4%. Amongst benign lesions found, the most frequently occurring were pleomorphic adenome and Warthin's tumour. MRI could accurately identify the histopathological type in 90% of such cases, whilst FNAB identified 89.1%.

Conclusion: In distinguishing between benign and malignant neoplastic lesions of the parotid gland, FNAB and MRI have similar abilities. Although MRI is unable to adequately predict the histopathological subtype in malignant lesions, unlike FNAB, its role in surgical planning and tumour staging remains highly significant.

Keywords

Magnetic Resonance Imaging, Fine Needle Aspiration Biopsy, Parotid Gland

References

• 1. Cummings CW, Flint PW, Harker LA, et al. Salivary glands. In: Cummings Otolaryngology Head and Neck Surgery. 5th ed. Philadelphia: Elsevier Mosby; 2005. p. 1162-99.
• 2. Aversa S, Ondolo C, Bollito E, Fadda G, Conticello S. Preoperative cytology in the management of parotid neoplasms. Am J Otolaryngol 2006; 27: 96-100.
• 3. Inohara H, Akahani S, Yamamoto Y, et al. The role of fine-needle aspiration cytology and magnetic resonance imaging in the management of parotid mass lesions. Acta Otolaryngol 2008; 128: 1152-8.
• 4. Tandon S, Shahab R, Benton JI. Fine-needle aspiration cytology in a regional head and neck cancer center: comparison with a systematic review and meta-analysis. Head Neck 2008; 30: 1246-52.
• 5. Que Hee CG, Perry CF. Fine-needle aspiration cytology of parotid tumours: is it useful? ANZ J Surg 2001; 71: 345-8
• 6. Brennan PA, Davies B, Poller D, et al. Fine needle aspiration cytology (FNAC) of salivary gland tumours: repeat aspiration provides further information in cases with an unclear initial cytological diagnosis. Br J Oral Maxillofac Surg 2010; 48: 26-9.
• 7. Atay G, Cabbarzade C, Kayahan B, et al. The role of fine needle aspiration cytology and magnetic resonance imaging in the management of parotid masses. KBB Forum 2013; 12: 55-61.
• 8. Yerli H, Aydin E, Haberal N, Harman A, Kaskati T, Alibek S. Diagnosing common parotid tumours with magnetic resonance imaging including diffusion-weighted imaging vs fine-needle aspiration cytology: a comparative study. Dentomaxillofac Radiol 2010; 39: 349-55.
• 9. Stathopoulos P, Igoumenakis D, Smith WP. Partial superficial, superficial, and total parotidectomy in the management of benign parotid gland tumors: a 10-year prospective study of 205 patients. J Oral Maxillofac Surg 2018; 76: 455-9.
• 10. Sood S, McGurk M, Vaz F. Management of salivary gland tumours: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol 2016; 130:142-9.
• 11. Jandu M, Webster K. The role of operator experience in fine needle aspiration cytology of head and neck masses. Int J Oral Maxillofac Surg 1999; 28: 441-4.
• 12. Alphs HH, DW Eisele, WH Westra. The role of fine needle aspiration in the evaluation of parotid masses. Curr Opin Otolaryngol Head Neck Surg 2006; 14: 62-6.
• 13. Lim CM, They J, Loh KS, Chao SS, Lim LH, Tan LK. Role of fine needle aspiration cytology in the evaluation of parotid tumours. ANZ J Surg 2007; 77: 742-4.
• 14. Schindler S, Nayar R, Dutra J, Bedrossian CW. Diagnostic challenges in aspiration cytology of the salivary glands. In Seminars in diagnostic pathology 2001; 18: 124-6.
• 15. Lin AC, Bhattacharyya N. The utility of fine needle aspiration in parotid malignancy. Otolaryngol Head Neck Surg 2007; 136: 793-8.
• 16. Contucci AM, Corina L, Sergi B, Fadda G, Paludetti G. Correlation between fine needle aspiration biopsy and histologic findings in parotid masses. Personal experience. Acta Otorhinolaryngol Ital 2003; 23: 314-8.
• 17. Jan IS, Chung PF, Weng MH, et al. Analysis of fine ne edle aspiration cytology of the salivary gland. J Formos Med Assoc 2008; 107: 364-70.
• 18. Brandwein-Gensler M, Bell D, Inagaki H, et al. Who classification of Head and Neck Tumours, 4th ed. İnternational Agency for Research on Cancer (IARC): Lyon, France, 2017. p.159-90.
• 19. Bron LP, O'Brien CJ. Facial nerve function after parotidectomy. Arch Otolaryngol Head Neck Surg 1997; 123: 1091-6.
• 20. Ishibashi M, Fujii S, Kawamoto K, et al. Capsule of parotid gland tumor: evaluation by 3.0 T magnetic resonance imaging using surface coils. Acta Radiol 2010; 51: 1103-10
• 21. Tryggvason G, Gailey MP, Hulstein SL, et al. Accuracy of fine-needle aspiration and imaging in the preoperative workup of salivary gland mass lesions treated surgically. Laryngoscope 2013; 123: 158-63.
• 22. Paris J, Facon F, Pascal T, Chrestian MA, Moulin G, Zanaret M. Preoperative diagnostic values of fineneedle cytology and MRI in parotid gland tumors. Eur Arch Otorhinolaryngol 2005; 262: 27-31.
• 23. Habermann CR, Arndt C, Graessner J, et al. Diffusion-weighted echo-planar MR imaging of primary parotid gland tumors: is a prediction of different histologic subtypes possible? AJNR Am J Neuroradiol. 2009; 30: 591-6.
• 24. Alibek S, Zenk J, Bozzato A, et al. The value of dynamic MRI studies in parotid tumors. Acad Radiol. 2007 ;14:701-10.