Potential of ultrasound diagnosis for parotid tumors: Analysis of qualitative and quantitative parameters

Objective Histology of parotid tumors determines the extent of surgery. The aim was to test ultrasound (US) contrast enhancer-kinetics to identify histologic entities, possibly being superior to qualitative morphological parameters. Study Design In a cross-sectional assessment of ultrasound diagnosis, the subjective US-classification was compared with contrast analysis with histology as gold standard. Subjects and Methods A total of 64 male and 61 female patients with a mean age of 54 years were included, with 13 malignant tumors. These were classified with US morphology, then time-dependent contrast medium analysis. Results A total of 92.8% of tumors were classified correctly as malignant or benign. The sensitivity, specificity, positive- and negative-predictive values were 66.7%, 86.3%, 60.6%, and 89.1% for differentiating Warthin tumors, but only 46.2%, 98.2%, 75%, and 94% for malignant lesions. Contrast parameters yielded significant parameters for benign tumors, not for malignant entities. Conclusion Although contrast medium analysis provided statistical criteria, these, however, do not possess the ability to improve the diagnostic prediction of tumor histology. Neither the morphologic classification nor contrast medium analysis was able to identify a malignant lesion sufficiently.

Download Full-text

Computed Tomography and Ultrasonography in Parotid Tumors

Acta Radiologica ◽

10.1177/028418518903000103 ◽

1989 ◽

Vol 30 (1) ◽

pp. 11-15 ◽

Cited By ~ 3

Author(s):

M. Isaza ◽

J. Ikezoe ◽

S. Morimoto ◽

S. Takashima ◽

K. Kadowaki ◽

...

Keyword(s):

Computed Tomography ◽

Malignant Tumors ◽

Malignant Lesion ◽

Benign Tumors ◽

Parotid Tumor ◽

Clinical Appearance ◽

Parotid Tumors ◽

Conventional Ct

To determine the most appropriate radiographic approach to parotid tumors, computed tomography (CT) was performed in 65 patients with 33 benign tumors, 19 malignant tumors, 3 abscesses and 10 other lesions with a clinical appearance of tumor. In 22 of the 65 cases CT-sialography and in 26 ultrasonography (US) were also performed. The mass was well recognized on CT without sialography in all patients, and the lesion was also well evaluated in all those examined with US. At CT-sialography the tumor was well shown, but this method made it difficult to differentiate a benign from a malignant lesion, because the character of the delineation and the border of the tumor were difficult to evaluate. It is concluded that US and CT without sialography are satisfactory for evaluating the parotid tumor, and the indication for CT-sialography is limited to those cases in which the tumor is demonstrated on US, but is unclear on conventional CT.

Download Full-text

Retrospective study on parotid gland tumors

ORL ro ◽

10.26416/orl.33.4.2016.155 ◽

2016 ◽

Vol 4 (1) ◽

pp. 22-23

Author(s):

Ibric Cioranu ◽

Vlad Petrescu Seceleanu ◽

Viorel Ibric Cioranu ◽

Andreea Smarandache ◽

Sorin Vasilescu ◽

...

Keyword(s):

Malignant Tumors ◽

Maxillofacial Surgery ◽

Squamous Carcinoma ◽

Benign Tumors ◽

Warthin Tumor ◽

Parotid Tumors ◽

Non Hodgkin Lymphoma ◽

Adenoid Cystic ◽

Modal Treatment ◽

Surgery Department

During 2011-2012, 56 patients diagnosed with parotid tumors were admitted to the Maxillofacial Surgery Department of “Lucian Blaga” University and in Euroclinic Hospital. 72% were benign tumors and 28% malignant. All patients received surgical treatment (total or partial parotidectomy). For the malignant tumors, radiotherapy was added to the modal treatment (94% of the cases). Pleomorphic adenoma was encountered in 70% of the benign cases, followed by Warthin tumor in 15%. Adenoid cystic carcinoma was noticed in 31% of the malignant cases, mucoepidermoid carcinoma in 25% of the cases, and squamous carcinoma and non-Hodgkin lymphoma on 12.5% of the malignant cases.

Download Full-text

Epidemiologic Characteristics of Salivary Gland Tumors in an Iranian Population

Shiraz E-Medical Journal ◽

10.5812/semj.107675 ◽

2021 ◽

Vol In Press (In Press) ◽

Author(s):

Nafise Shamloo ◽

Alireza Ghanadan ◽

Fahimeh Sadat Hashemian ◽

Maedeh Ghorbanpour

Keyword(s):

Salivary Gland ◽

Adenoid Cystic Carcinoma ◽

Salivary Glands ◽

Pleomorphic Adenoma ◽

Malignant Tumors ◽

The Body ◽

Salivary Gland Tumors ◽

Benign Tumors ◽

Cross Sectional ◽

Adenoid Cystic

Background: Salivary gland tumors include a wide variety of benign and malignant tumors in the oral and maxillofacial region. Although these tumors are not common, they are not rare. The prevalence of these tumors varies with regard to age, gender, and their location in the body. Objectives: This study aimed to evaluate the frequency of benign and malignant salivary gland tumors in patients referred to three referral hospitals in Tehran, Iran. Methods: This retrospective cross-sectional study examined the demographic and pathologic records of the patients with salivary gland tumors submitted to the Department of Pathology of Amir Alam, Loghman Hakim, and Shohada Hospitals from 2005 to 2016. In this study, the histological variants of salivary gland tumors and clinical parameters such as age, gender, and the location of the tumor were examined. The clinical data were analyzed using SPSS software version 21. Results: Of 137632 patient records, 1180 cases were salivary gland tumors. Pleomorphic adenoma in 794 cases (67.3%) and adenoid cystic carcinoma in 109 cases (9.2%) were the most common tumors, respectively. Salivary gland tumors were more common in males, and the participants’ mean age was 42.86 ± 16.5 years. The most common site was parotid and minor salivary glands, with 937 (79.4%) and 137 (12%) cases, respectively. Conclusions: In this study, the most common benign tumor was pleomorphic adenoma in the parotid gland, and the most common malignant tumor was adenoid cystic carcinoma in the major salivary glands. Furthermore, benign tumors were more frequent than malignant tumors.

Download Full-text

Evaluation of a Rapid Diagnostic Test Currently Being Used in the Management of Malaria in Patients of the Hia/Chu-Parakou and the Boko Zone Hospital in Northern Benin

Austin Journal of Infectious Diseases ◽

10.26420/austinjinfectdis.2021.1057 ◽

2021 ◽

Vol 8 (4) ◽

Author(s):

Tokponnon F ◽

◽

Osse R ◽

Houessou C ◽

Akogbeto M ◽

...

Keyword(s):

Diagnostic Test ◽

Rapid Diagnostic Test ◽

Probabilistic Method ◽

Health Centers ◽

Patient Identification ◽

Cross Sectional ◽

Predictive Values ◽

Parasitological Diagnosis ◽

Sensitivity Specificity ◽

Adequate Management

Parasitological diagnosis is a fundamental element in the adequate management of the disease. In the last decade, there has been a resurgence of interest in the development of malaria Rapid Diagnostic Test (RDT) kits. This is the case with SD Bioline Malaria Ag Pf, which searches for HRP2 antigen by immunochromatography. The objective of this study is to compare the results of RDT SD Bioline Malaria Ag Pf in use with the results of Thick Gout (TG) in the biological diagnosis of malaria. This was a cross-sectional, descriptive and evaluative study carried out at the Hôpital d’Instruction des Armées-Center Hospitalier et Universitaire de Parakou and at the Boko zone hospital from April 20 to July 30, 2015. Patient identification, we used the non-probabilistic method and the convenience choice technique. The study involved 503 patients. The results of this study showed a good performance of the RDT SD Bioline Malaria Ag Pf. Among the 503 patients, 199 or 39.6% were positive for the RDT against 180 or 35.8% positive for the Thick Gout (TG). Sensitivity, specificity, positive and negative predictive values of the test compared to the thick film were respectively (91.7%, 89.5%, 82.9, 95) and the Kappa coefficient of 0.88 testifies a good match. False positive cases are noted in patients on treatment and even after recovery due to the persistence of the HRP2 antigen in the blood. However, it constitutes an interesting alternative to the management of malaria. At the end of this study, we suggest continuing the use of RDTs in health centers where microscopy is absent and/or reinforcing microscopy, and to strengthen staff training in the management of malaria cases.

Download Full-text

Use-fullness of dynamic contrast-enhanced MR imaging and diffusion weighted MR imaging for differentiation of benign and malignant parotid tumors

10.36879/jcmi.18.000101 ◽

2018 ◽

pp. 1-6

Keyword(s):

Mr Imaging ◽

Malignant Tumors ◽

Dce Mri ◽

Dynamic Contrast Enhanced ◽

Parotid Tumors ◽

Contrast Enhanced ◽

Type C ◽

Sensitivity Specificity ◽

And Diffusion ◽

Malignant Parotid Tumors

Objectives: To evaluate the usefullness of dynamic contrast-enhanced MR Imaging (DCE-MRI) and diffusion weighted imaging (DWI) for differentiating benign from malignant parotid tumors. Methods: Prospectively,DCE-MRI and DWI were performed in 112 patients, with 148 confirmed parotid masses. The differential optimal thresholds were determined. Results: WConsidering tumors with time-intensity curve (TIC) Type C as malignant, sensitivity, specificity, accuracy were 95%, 76%, 79%, respectively. Considering ADC threshold values 0.709×10-3mm2 /s<ADC<0.948×10-3mm2 /s as malignant, sensitivity, specificity, accuracy were 75%, 78%, 78%, respectively. Considering TIC Type C and ADC values 0.709×10-3mm2 /s<ADC<0.948×10-3mm2 /s as malignant, sensitivity, specificity, accuracy were 75%, 91%, 89%, respectively. With threshold Kep<1.118 min-1 and Ve >0.315 between Warthin and malignant tumors, threshold Kep>0.555 min-1 and Ve <0.605 between pleomorphic adenomas and malignant tumors, sensitivity, specificity, accuracy for malignancy were 70% vs 90%, 96% vs 74%, 92% vs 80%, respectively. Conclusion: DCE-MRI and DWI provide more information in differentiating benign from malignant parotid tumors.

Download Full-text

Validation of Psoas Muscle Index as a predictor of successful extubation in elderly intensive care patients: a retrospective cohort study

10.21203/rs.2.22396/v1 ◽

2020 ◽

Author(s):

Fumimasa Kobori ◽

Kazunari Azuma ◽

Shiro Mishima ◽

Jun Oda

Keyword(s):

Intensive Care ◽

Psoas Muscle ◽

Extubation Failure ◽

Cross Sectional Area ◽

Sectional Area ◽

Cross Sectional ◽

Predictive Values ◽

Failure Group ◽

Success Group ◽

Sensitivity Specificity

Abstract Background Extubation failure-associated factors haven't been investigated in elderly patients. We hypothesized that psoas cross-sectional area, an emerging indicator of frailty, can be a predictor of extubation outcomes. Methods This retrospective study analyzed data from patients admitted between January and April 2016 at the intensive care unit (ICU) of the Tokyo Medical University Hospital. Patients were considered eligible if aged ≥65 years, required intubation at the emergency room, and were admitted to ICU for <24 h. Overall, 39 ICU patients were eligible and categorized into two groups: extubation success (n = 24) and extubation failure (n = 15) groups. The psoas cross-sectional area was measured at the third lumbar level on computer tomography images. Regions of interest were drawn freehand to outline the left and right psoas by an emergency physician. The average left and right psoas cross-sectional areas, used as the patient’s psoas cross-sectional area, were calculated. Psoas Muscle Index (PMI) was defined as the psoas cross-sectional area/height 2 . Primary outcome was to evaluate differences between the psoas cross-sectional area and f(PMI) between the groups, if any. Secondary outcome was to derive cut-off values using ROC curves. Results Both groups were comparable in terms of demographic characteristics. Psoas cross-sectional area (success group, 1776.5 ± 498.2 mm 2 , failure group, 1391.2 ± 589.4 mm 2 ; p = 0.022) and PMI (success group, 1089 ± 270.7 mm 2 /m 2 , failure group, 889 ± 338.5 mm 2 /m 2 ; p = 0.032) were significantly greater in the success group than in the failure group. ROC curve of the psoas cross-sectional area and PMI were used to calculate sensitivity and speciﬁcity. ROC AUC was 0.74 for psoas cross-sectional area, and at a cut-off of 1260 points, the sensitivity, speciﬁcity, and positive and negative predictive values were 95.8%, 60.0%, 79.3%, and 90.0%, respectively. ROC AUC for PMI was 0.73, and at a cut-off of 812 points, the sensitivity, speciﬁcity, and positive and negative predictive values were 95.8%, 46.7%, 74.2%, and 87.5%, respectively. Conclusions The psoas cross-sectional area and PMI can predict extubation outcomes in elderly intensive care patients.

Download Full-text

Diagnostic and Prognostic Validity of Proadrenomedullin among Neonates with Sepsis in Tertiary Care Hospitals of Southern India

International Journal of Pediatrics ◽

10.1155/2018/7908148 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Raja Kannan ◽

Suchetha S. Rao ◽

Prasanna Mithra ◽

B. Dhanashree ◽

Shantharam Baliga ◽

...

Keyword(s):

Clinical Outcome ◽

Neonatal Sepsis ◽

Tertiary Care ◽

Cross Sectional Study ◽

Cross Sectional ◽

Predictive Values ◽

Clinical Sepsis ◽

A Value ◽

Sepsis Screen ◽

Sensitivity Specificity

Introduction. To evaluate Proadrenomedullin (Pro-ADM) as the diagnostic and prognostic marker in neonatal sepsis. Materials and Methods. In this cross-sectional study, Pro-ADM levels were estimated in 54 neonates with clinical sepsis and positive sepsis screen (cases) and 54 controls without clinical sepsis. Repeat Pro-ADM levels were estimated after 72 hours in cases. Pro-ADM levels were compared with the clinical outcome. Results and Discussion. Median Pro-ADM levels in cases were 31.8 (IQR: 27.8-39.4) pmol/ml which was significantly higher than controls 5.1 (IQR; 3.1-7.7) pmol/ml. From the constructed ROC curve, a value of 14.5 pmol/ml was taken as the cut-off for sepsis. Pro-ADM had 100% sensitivity, specificity, and positive predictive values (PPV) in detecting sepsis at 14.5 pmol/ml. Among cases, a decrease in Pro-ADM level by 10 pmol/ml was associated with 99% survival. Pro-ADM value of 35 pmol/ml had 100% specificity and PPV in predicting mortality. Conclusion. Pro-ADM can be used as a single biomarker for detecting neonatal sepsis, predicting clinical outcome and prognosis.

Download Full-text

Diagnostic accuracy of computed tomography to identify adenomas among adrenal incidentalomas in an endocrinological population

Acta Endocrinologica ◽

10.1530/eje-17-1056 ◽

2018 ◽

Vol 178 (5) ◽

pp. 439-446 ◽

Cited By ~ 8

Author(s):

M Marty ◽

D Gaye ◽

P Perez ◽

C Auder ◽

M L Nunes ◽

...

Keyword(s):

Computed Tomography ◽

Malignant Tumors ◽

Correlation Coefficients ◽

University Hospital ◽

Benign Tumors ◽

Adrenal Incidentalomas ◽

Reference Standard ◽

Quantitative Ct ◽

Endocrine Society ◽

Predictive Values

Context The recent recommendations of the European Endocrine Society states that the performance of computed tomography (CT) to characterize ‘true' adrenal incidentalomas (AIs) remains debatable. Objective To determine relevant thresholds for usual CT parameters for the diagnosis of benign tumors using robust reference standard among a large series of ‘true’ AIs recruited in an endocrinological setting. Design Retrospective study of 253 AIs in 233 consecutive patients explored in a single university hospital: 183 adenomas, 33 pheochromocytomas, 23 adrenocortical carcinomas, 5 other malignant tumors and 9 other benign tumors. Reference standard was histopathology in 118 AIs, biological diagnosis of pheochromocytoma in 2 AIs and size stability after at least 1 year of follow-up in 133 AIs. Methods Sensitivity, specificity and positive and negative predictive values were estimated for various thresholds of size, unenhanced attenuation (UA), relative and absolute wash-out (RPW, APW) of contrast media. 197 scans were reviewed independently in a blinded fashion by two expert radiologists to assess inter-observer reproducibility of measurements. Results Criteria associated with a 100% positive predictive value for the diagnosis of benign AI were: a combination of size and UA: 30 mm and 20 HU or 40 mm and 15 HU, respectively; RPW >53%; and APW >78%. Non-adenomatous AIs with rapid contrast wash-out were exclusively benign pseudocysts and pheochromocytomas, suggesting that classical thresholds of 60% and 40% for APW and RPW, respectively, can be safely used for patients with normal metanephrine values. Inter-observer reproducibility of all parameters was excellent (intra-class correlation coefficients: 0.96–0.99). Conclusions Our study, the largest conducted in AIs recruited in an endocrinological setting, suggests safe thresholds for quantitative CT parameters to avoid false diagnoses of benignity.

Download Full-text

Small Subcutaneous Soft Tissue Tumors (<5 cm) Can Be Sarcomas and Contrast-Enhanced Ultrasound (CEUS) Is Useful to Identify Potentially Malignant Masses

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17238868 ◽

2020 ◽

Vol 17 (23) ◽

pp. 8868

Author(s):

Armanda De Marchi ◽

Simona Pozza ◽

Lorena Charrier ◽

Filadelfo Cannone ◽

Franco Cavallo ◽

...

Keyword(s):

Soft Tissue ◽

Malignant Tumors ◽

Univariate Analysis ◽

Soft Tissue Tumors ◽

Deep Fascia ◽

Contrast Enhanced Ultrasound ◽

Predictive Values ◽

Contrast Enhanced ◽

Potentially Malignant ◽

Sensitivity Specificity

Subcutaneous masses smaller than 5 cm can be malignant, in contrast with the international guidelines. Ultrasound (US) and magnetic resonance imaging (MRI) are useful to distinguish a potentially malignant mass from the numerous benign soft tissue (ST) lesions. Contrast-enhanced ultrasound (CEUS) was applied in ST tumors, without distinguishing the subcutaneous from the deep lesions. We evaluated CEUS and MRI accuracy in comparison to histology in differentiating malignant from nonmalignant superficial ST masses, 50% smaller than 5 cm. Sensitivity, specificity, and positive and negative predictive values (PPV, NPV) with their 95% confidence intervals (CI) were calculated. Of malignant cases, 44.4% measured ≤5 cm. At univariate analysis, no statistically significant differences emerged between benign and malignant tumors in relation with clinical characteristics, except for relationship with the deep fascia (p = 0.048). MRI accuracy: sensitivity 52.8% (CI 37.0, 68.0), specificity 74.1% (CI 55.3, 86.8), PPV 73.1% (CI 53.9, 86.3), and NPV 54.1% (CI 38.4, 69.0). CEUS accuracy: sensitivity 75% (CI 58.9, 86.3), specificity 37% (CI 21.5, 55.8), PPV 61.4% (CI 46.6, 74.3), and NPV 52.6% (CI 31.7, 72.7). CEUS showed a sensitivity higher than MRI, whereas PPV and NPV were comparable. Also, masses measuring less than 5 cm can be malignant and referral criteria for centralization could be revised.

Download Full-text

FSH and LH serum/tumor fluid ratios and malignant tumors of the ovary.

Endocrine Related Cancer ◽

10.1677/erc.0.0110315 ◽

2004 ◽

Vol 11 (2) ◽

pp. 315-321 ◽

Cited By ~ 23

Author(s):

I Rzepka-G√≥rska ◽

A Chudecka-G≈Çaz ◽

B Kosmowska

Keyword(s):

Ovarian Cancer ◽

Differential Diagnosis ◽

Malignant Tumors ◽

Ovarian Tumors ◽

Predictive Values ◽

Epithelial Tumors ◽

Ovarian Carcinogenesis ◽

Benign Ovarian Tumors ◽

Sensitivity Specificity

The aim of this work was to compare mean concentrations of gonadotropins in serum and fluid from malignant and benign ovarian tumors. We enrolled 126 patients diagnosed with malignant epithelial tumors (n=40), borderline epithelial tumors (n=14), benign cystadenomas (n=28) and simple cysts (n=44) of the ovary. Premenopausal and postmenopausal subgroups were formed in each group. The concentration of FSH and LH was measured in serum and tumor fluid and the serum/tumor fluid ratio was calculated. The results in each group were compared and the sensitivity, specificity, positive and negative predictive values were determined. Mean concentrations of both gonadotropins in ovarian cancer fluid were significantly higher than in the remaining groups (P ranged from <0.005 to <0.0001). Mean serum/fluid ratios were lowest in ovarian cancer (FSH=2.91, LH=4.19). Our findings support the hypothesis that gonadotropins are involved in ovarian carcinogenesis and suggest that gonadotropin serum/tumor fluid ratios could be of value in the differential diagnosis of functional and organic cysts of the ovary.

Download Full-text