Real-Time Sonoelastography of Parotid Gland Tumors

We sought to determine the performance of real-time sonoelastography in the differential diagnosis of parotid gland tumors.

Between April, 2014, and June, 2015, 54 parotid gland masses were examined by ultrasound and strain sonoelastography in 46 patients. Real-time sonoelastography using the elasticity score (E-index), which gives an absolute value between 0 (softest) and 6 (hardest), was performed. Demographic characteristics, histopathologic examination, and difference in elasticity scores between benign and malignant masses were evaluated.

The mean age of the patients was 60.01 ± 2.97 years, and 56.52% of the patients were male (n = 26). Among the 54 parotid gland masses, 44 (81.5%) were benign and 10 (18.5%) were malignant tumors, 63% (n = 34) of the lesions being on the right side. The diagnoses as benign tumors consisted of Warthin tumor (n = 18, 33.3%), pleomorphic adenoma (n = 8, 14.8%) and other benign tumors (n = 18, 33.3%). The mean elasticity score and the size of all tumors were 2.87 ± 0.96 and 23.68 ± 12.38 mm, respectively. The mean elasticity score for benign tumors was 2.75 ± 0.95, and for malignant tumors it was 3.44 ± 0.85 (P = .034).

According to our results, real-time strain sonoelastography seems to have additional value over routine sonographic evaluation of parotid gland tumors in the differential diagnosis of benign and malignant parotid masses. However, with a small sample of malignant cases and appreciable overlap of the stiffness of benign and malignant masses, caution must be applied because the findings may not be representative of all patients with a parotid gland tumor.