Vascular pattern analysison microvascular sonography for differentiation of pleomorphic adenomas and warthin tumors of salivary glands

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Abstract

Objectives-Pleomorphic adenomas and Warthin tumors are the most common salivary gland tumors. It is important to differentiate between them because at least a partial parotidectomy is necessary for pleomorphic adenomas, whereas enucleation is sufficient for Warthin tumors. This study aimed to evaluate the usefulness of vascular pattern analysis using microvascular sonography to differentiate between the tumors. Methods-Sixty-two patients with pathologically proven pleomorphic adenomas (n=38) and Warthin tumors (n=24) were included. For all tumors, grayscale, power Doppler, and microvascular sonographic examinations were performed. Differences in vascular patterns (vascular distribution and internal vascularity) on power Doppler and microvascular sonography as well as grayscale sonographic features (size, shape, border, echogenicity, heterogeneity, and cystic change) between pleomorphic adenomas and Warthin tumors were evaluated. A comparison of diagnostic performances of grayscale sonography with power Doppler sonography and grayscale sonography with microvascular sonography was performed. The level of interobserver agreement between 2 reviewers in diagnosing tumors was evaluated. Results-No grayscale sonographic features showed a significant difference between the tumors. Vascular distributions and internal vascularity on power Doppler sonography (P=.01 and.002) and microvascular sonography (both P<.001) were all significantly different. The diagnostic accuracy of grayscale sonography with microvascular sonography (79.0%) was higher than that of grayscale sonography with power Doppler sonography (72.6%). This difference was significant according to the McNemar test (P=.004). Interobserver agreement was excellent in diagnosing tumors on both grayscale sonography with power Doppler sonography (κ=0.83) and grayscale sonography with microvascular sonography (κ=0.94). Conclusions-Vascular pattern analysis using microvascular sonography with other sonographic features is helpful for differentiating between pleomorphic adenomas and Warthin tumors.

Original languageEnglish
Pages (from-to)613-620
Number of pages8
JournalJournal of Ultrasound in Medicine
Volume37
Issue number3
DOIs
Publication statusPublished - 2018 Mar 1

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Adenolymphoma
Pleomorphic Adenoma
Salivary Glands
Blood Vessels
Ultrasonography
Doppler Ultrasonography
Neoplasms
Glandular and Epithelial Neoplasms

Keywords

  • Doppler (techniques/physics)
  • Head and neck
  • Microvascular sonography
  • Pleomorphic adenoma
  • Power doppler sonography
  • Salivary gland tumor
  • Superb microvascular imaging
  • Warthin tumor

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

Cite this

@article{dcf5f03380b84259929a60e112b9480a,
title = "Vascular pattern analysison microvascular sonography for differentiation of pleomorphic adenomas and warthin tumors of salivary glands",
abstract = "Objectives-Pleomorphic adenomas and Warthin tumors are the most common salivary gland tumors. It is important to differentiate between them because at least a partial parotidectomy is necessary for pleomorphic adenomas, whereas enucleation is sufficient for Warthin tumors. This study aimed to evaluate the usefulness of vascular pattern analysis using microvascular sonography to differentiate between the tumors. Methods-Sixty-two patients with pathologically proven pleomorphic adenomas (n=38) and Warthin tumors (n=24) were included. For all tumors, grayscale, power Doppler, and microvascular sonographic examinations were performed. Differences in vascular patterns (vascular distribution and internal vascularity) on power Doppler and microvascular sonography as well as grayscale sonographic features (size, shape, border, echogenicity, heterogeneity, and cystic change) between pleomorphic adenomas and Warthin tumors were evaluated. A comparison of diagnostic performances of grayscale sonography with power Doppler sonography and grayscale sonography with microvascular sonography was performed. The level of interobserver agreement between 2 reviewers in diagnosing tumors was evaluated. Results-No grayscale sonographic features showed a significant difference between the tumors. Vascular distributions and internal vascularity on power Doppler sonography (P=.01 and.002) and microvascular sonography (both P<.001) were all significantly different. The diagnostic accuracy of grayscale sonography with microvascular sonography (79.0{\%}) was higher than that of grayscale sonography with power Doppler sonography (72.6{\%}). This difference was significant according to the McNemar test (P=.004). Interobserver agreement was excellent in diagnosing tumors on both grayscale sonography with power Doppler sonography (κ=0.83) and grayscale sonography with microvascular sonography (κ=0.94). Conclusions-Vascular pattern analysis using microvascular sonography with other sonographic features is helpful for differentiating between pleomorphic adenomas and Warthin tumors.",
keywords = "Doppler (techniques/physics), Head and neck, Microvascular sonography, Pleomorphic adenoma, Power doppler sonography, Salivary gland tumor, Superb microvascular imaging, Warthin tumor",
author = "Inseon Ryoo and Sang-Il Suh and Lee, {Young Hen} and Seo, {Hyung Suk} and Seol, {Hae Young} and Jeong-Soo Woo and Kim, {Soo Chin}",
year = "2018",
month = "3",
day = "1",
doi = "10.1002/jum.14368",
language = "English",
volume = "37",
pages = "613--620",
journal = "Journal of Ultrasound in Medicine",
issn = "0278-4297",
publisher = "American Institute of Ultrasound in Medicine",
number = "3",

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TY - JOUR

T1 - Vascular pattern analysison microvascular sonography for differentiation of pleomorphic adenomas and warthin tumors of salivary glands

AU - Ryoo, Inseon

AU - Suh, Sang-Il

AU - Lee, Young Hen

AU - Seo, Hyung Suk

AU - Seol, Hae Young

AU - Woo, Jeong-Soo

AU - Kim, Soo Chin

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Objectives-Pleomorphic adenomas and Warthin tumors are the most common salivary gland tumors. It is important to differentiate between them because at least a partial parotidectomy is necessary for pleomorphic adenomas, whereas enucleation is sufficient for Warthin tumors. This study aimed to evaluate the usefulness of vascular pattern analysis using microvascular sonography to differentiate between the tumors. Methods-Sixty-two patients with pathologically proven pleomorphic adenomas (n=38) and Warthin tumors (n=24) were included. For all tumors, grayscale, power Doppler, and microvascular sonographic examinations were performed. Differences in vascular patterns (vascular distribution and internal vascularity) on power Doppler and microvascular sonography as well as grayscale sonographic features (size, shape, border, echogenicity, heterogeneity, and cystic change) between pleomorphic adenomas and Warthin tumors were evaluated. A comparison of diagnostic performances of grayscale sonography with power Doppler sonography and grayscale sonography with microvascular sonography was performed. The level of interobserver agreement between 2 reviewers in diagnosing tumors was evaluated. Results-No grayscale sonographic features showed a significant difference between the tumors. Vascular distributions and internal vascularity on power Doppler sonography (P=.01 and.002) and microvascular sonography (both P<.001) were all significantly different. The diagnostic accuracy of grayscale sonography with microvascular sonography (79.0%) was higher than that of grayscale sonography with power Doppler sonography (72.6%). This difference was significant according to the McNemar test (P=.004). Interobserver agreement was excellent in diagnosing tumors on both grayscale sonography with power Doppler sonography (κ=0.83) and grayscale sonography with microvascular sonography (κ=0.94). Conclusions-Vascular pattern analysis using microvascular sonography with other sonographic features is helpful for differentiating between pleomorphic adenomas and Warthin tumors.

AB - Objectives-Pleomorphic adenomas and Warthin tumors are the most common salivary gland tumors. It is important to differentiate between them because at least a partial parotidectomy is necessary for pleomorphic adenomas, whereas enucleation is sufficient for Warthin tumors. This study aimed to evaluate the usefulness of vascular pattern analysis using microvascular sonography to differentiate between the tumors. Methods-Sixty-two patients with pathologically proven pleomorphic adenomas (n=38) and Warthin tumors (n=24) were included. For all tumors, grayscale, power Doppler, and microvascular sonographic examinations were performed. Differences in vascular patterns (vascular distribution and internal vascularity) on power Doppler and microvascular sonography as well as grayscale sonographic features (size, shape, border, echogenicity, heterogeneity, and cystic change) between pleomorphic adenomas and Warthin tumors were evaluated. A comparison of diagnostic performances of grayscale sonography with power Doppler sonography and grayscale sonography with microvascular sonography was performed. The level of interobserver agreement between 2 reviewers in diagnosing tumors was evaluated. Results-No grayscale sonographic features showed a significant difference between the tumors. Vascular distributions and internal vascularity on power Doppler sonography (P=.01 and.002) and microvascular sonography (both P<.001) were all significantly different. The diagnostic accuracy of grayscale sonography with microvascular sonography (79.0%) was higher than that of grayscale sonography with power Doppler sonography (72.6%). This difference was significant according to the McNemar test (P=.004). Interobserver agreement was excellent in diagnosing tumors on both grayscale sonography with power Doppler sonography (κ=0.83) and grayscale sonography with microvascular sonography (κ=0.94). Conclusions-Vascular pattern analysis using microvascular sonography with other sonographic features is helpful for differentiating between pleomorphic adenomas and Warthin tumors.

KW - Doppler (techniques/physics)

KW - Head and neck

KW - Microvascular sonography

KW - Pleomorphic adenoma

KW - Power doppler sonography

KW - Salivary gland tumor

KW - Superb microvascular imaging

KW - Warthin tumor

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JF - Journal of Ultrasound in Medicine

SN - 0278-4297

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