The Role of Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) in Differentiating Salivary Gland Neoplasms Compared with Fine-Needle Aspiration (FNA).

Background/

Objectives

Salivary gland tumors account for 2.0-6.5% of all head and neck neoplasms, approximately 70% of which are located in the parotid gland. Preoperative determination of tumor histology is a crucial step in the diagnostic and therapeutic pathway because it guides the choice of surgical technique, affecting the achievement of adequate resection margins and preservation of the facial nerve. Fine-needle aspiration (FNA) cytology is the most commonly used cytologic method. However the complex and heterogenous histologic architecture of salivary gland tumors is associated with a significant proportion of false results. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is a valuable complementary diagnostic tool that enables noninvasive analysis based on perfusion assessment and tissue characterization. The aim of this study is to evaluate the utility of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in the diagnosis of salivary gland tumors and to compare its diagnostic performance with fine-needle aspiration (FNA).

Methods

We present a study of 25 patients who underwent DCE-MRI, FNA and postoperative histopathologic examination.

Results

Among the 25 patients included, DCE-MRI results were concordant with the postoperative histopathologic diagnosis in 76% of cases, whereas only 36% of positive FNA results correlated with the histopathologic diagnosis.

Conclusions

DCE-MRI demonstrates greater correlation with postoperative histopathologic diagnosis compared with FNA. Advantages of DCE-MRI include its noninvasive nature and the ability to image the entire region of interest. Key benefits of FNA are its wide availability and low cost. Selecting the most appropriate preoperative diagnostic modality can positively influence subsequent diagnostic and therapeutic management.