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Le Bourlout Y, Rehell M, Kelppe J, Rautava J, Perra E, Rantanen J, Ehnholm G, Hayward N, Nyman K, Pritzker KPH, Tarkkanen J, Atula T, Aro K, Nieminen HJ. Ultrasound-Enhanced Fine-Needle Biopsy Improves Yield in Human Epithelial and Lymphoid Tissue. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:1247-1254. [PMID: 38834492 DOI: 10.1016/j.ultrasmedbio.2024.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 03/22/2024] [Accepted: 04/27/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVE Needle biopsy is a common technique used to obtain cell and tissue samples for diagnostics. Currently, two biopsy methods are widely used: (i) fine-needle aspiration biopsy (FNAB) and (ii) core needle biopsy (CNB). However, these methods have limitations. Recently, we developed ultrasound-enhanced fine-needle aspiration biopsy (USeFNAB), which employs a needle that flexurally oscillates at an ultrasonic frequency of ∼32 kHz. The needle motion contributes to increased tissue collection while preserving cells and tissue constructs for pathological assessment. Previously, USeFNAB has been investigated only in ex vivo animal tissue. The present study was aimed at determining the feasibility of using USeFNAB in human epithelial and lymphoid tissue. METHODS Needle biopsy samples were acquired using FNAB, CNB and USeFNAB on ex vivo human tonsils (N = 10). The tissue yield and quality were quantified by weight measurement and blinded pathologists' assessments. The biopsy methods were then compared. RESULTS The results revealed sample mass increases of, on average, 2.3- and 5.4-fold with USeFNAB compared with the state-of-the-art FNAB and CNB, respectively. The quality of tissue fragments collected by USeFNAB was equivalent to that collected by the state-of-the-art methods in terms of morphology and immunohistochemical stainings made from cell blocks as judged by pathologists. CONCLUSION Our study indicates that USeFNAB is a promising method that could improve tissue yield to ensure sufficient material for ancillary histochemical and molecular studies for diagnostic pathology, thereby potentially increasing diagnostic accuracy.
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Affiliation(s)
- Yohann Le Bourlout
- Medical Ultrasonics Laboratory (MEDUSA), Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
| | - Minna Rehell
- Medical Ultrasonics Laboratory (MEDUSA), Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland; Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jetta Kelppe
- Department of Pathology, HUSLAB, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jaana Rautava
- Department of Pathology, HUSLAB, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Emanuele Perra
- Medical Ultrasonics Laboratory (MEDUSA), Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
| | - Jouni Rantanen
- Medical Ultrasonics Laboratory (MEDUSA), Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
| | - Gösta Ehnholm
- Medical Ultrasonics Laboratory (MEDUSA), Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
| | - Nick Hayward
- Medical Ultrasonics Laboratory (MEDUSA), Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
| | - Kristofer Nyman
- Department of Radiology, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Kenneth P H Pritzker
- Departments of Laboratory Medicine and Pathobiology and Surgery, University of Toronto, Toronto, ON, Canada
| | - Jussi Tarkkanen
- Department of Pathology, HUSLAB, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo Atula
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Katri Aro
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Heikki J Nieminen
- Medical Ultrasonics Laboratory (MEDUSA), Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland.
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Al Olaimat MS, Al Qooz FS, Alzoubi ZR, Alsharaiah EM, Al Murdif AS, Alanazi MO. Efficiency of Fine-Needle Aspiration (FNA) in Relation to Tru-Cut Biopsy of Lateral Neck Swellings. Cureus 2024; 16:e64224. [PMID: 38988899 PMCID: PMC11234481 DOI: 10.7759/cureus.64224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2024] [Indexed: 07/12/2024] Open
Abstract
Background Lateral neck masses have always been difficult to diagnose without proposing a differential diagnosis. Fine-needle aspiration (FNA) was proposed to be a cost-effective method and less invasive than a tru-cut biopsy and may provide a provisional diagnosis in relation to cytopathology. FNA has also been shown to improve the diagnosis of neck masses such as cervical lymphadenopathy, neck cysts, and parotid masses, whether malignant or benign. This study aims to evaluate the accuracy of FNA cytopathology versus a tru-cut biopsy histopathological examination. Materials and methods This study was conducted retrospectively in King Hussein Medical Hospital, Royal Medical Services, Hashemite Kingdom of Jordan, from January 2019 to January 2024. Ethical approval was taken to conduct this study with reference number 06/2024. All patients included in this study have given verbal and written consent to perform FNA and surgical tru-cut biopsy. The inclusion of patients was based on any person above the age of 16 who underwent an FNA followed by a surgical biopsy to correlate with the primary diagnosis. Exclusion criteria involved any patient who missed one of the above criteria. Statistical analysis was performed using IBM SPSS v29 (IBM Corp., Armonk, NY, US) with significant results considered with a p-value <0.05. Results A total of 107 patients were included in this study. A correlation between FNA results and final histopathological biopsy was done with an accuracy of 90.6%, specificity of 94.3, predictive positive value of 73.6%, and negative predictive value of 94.3%. There was a statistical significance between FNA and tru-cut biopsy with a p-value of <0.001. Conclusion FNA is a great tool to consider when diagnosing lateral neck swellings. Since it was statistically significant, FNA should be considered for any lateral neck swelling before any surgical tru-cut biopsy for a definitive diagnosis.
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Affiliation(s)
| | - Fahad S Al Qooz
- Maxillofacial Surgery, King Hussein Medical Center, Amman, JOR
| | - Zaid R Alzoubi
- Maxillofacial Surgery, King Hussein Medical Center, Amman, JOR
| | | | - Ali S Al Murdif
- Maxillofacial Surgery, King Hussein Medical Center, Amman, JOR
| | - Mohammad O Alanazi
- Maxillofacial Surgery, King Abdulaziz Airbase Military Hospital, Dhahran, SAU
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Fikova A, Novak S, Kalfert D, Kuchar M, Zabrodsky M, Dostalova L, Balko J, Plzak J. Utility of fine-needle aspiration biopsy (FNAB) in parotid pleomorphic adenoma diagnosis and management. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2024; 168:156-161. [PMID: 37431621 DOI: 10.5507/bp.2023.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/13/2023] [Indexed: 07/12/2023] Open
Abstract
PURPOSE Pleomorphic adenoma (PA), the most common benign tumour of the parotid gland, requires accurate preoperative diagnosis owing to its capacity for malignant transformation. The aim of this study was to evaluate our experience with ultrasound-guided fine-needle aspiration biopsy (FNAB) in the diagnostic algorithm for patients with PA and to assess clinical outcomes for those with different surgical approaches. MATERIAL AND METHODS We carried out a retrospective analysis of patients treated for parotid gland mass between 2010 and 2016. These had had preoperative FNAB and had undergone subsequent surgery. RESULTS 165 patients had FNAB with the result of PA and the definitive histology confirmed PA in 159 cases (96.4%). On the other hand, in 179 patients, the definitive histology showed PA and the preoperative FNAB result corresponded in 159 cases (88.9%). The measured sensitivity, specificity and accuracy of ultrasound-guided FNAB in the diagnosis of PA were, respectively, 88.83%, 96.23% and 92.31%. Most of the patients underwent superficial or partial superficial parotidectomy, followed by extracapsular dissection which was associated with statistically lower risk of facial nerve injury (P=0.04). CONCLUSION Ultrasound-guided FNAB is simple, accurate and valuable in the diagnosis of PA and provides results that can lead to the choice of less invasive operative treatment.
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Affiliation(s)
- Alzbeta Fikova
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Stepan Novak
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - David Kalfert
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Martin Kuchar
- Department of Otorhinolaryngology and Head and Neck Surgery, Bulovka University Hospital, Prague, Czech Republic
| | - Michal Zabrodsky
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Lucie Dostalova
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Jan Balko
- Department of Pathology and Molecular Medicine, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Jan Plzak
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
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Żurek M, Fus Ł, Niemczyk K, Rzepakowska A. Salivary gland pathologies: evolution in classification and association with unique genetic alterations. Eur Arch Otorhinolaryngol 2023; 280:4739-4750. [PMID: 37439929 PMCID: PMC10562281 DOI: 10.1007/s00405-023-08110-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/03/2023] [Indexed: 07/14/2023]
Abstract
PURPOSE The correct classification of salivary gland pathologies is crucial for choosing a treatment method and determining the prognosis. Better outcomes are now achievable thanks to the introduction of new therapy approaches, such as targeted therapies for malignant salivary gland tumors. To apply these in clinical routine, a clear classification of the lesions is required. METHODS The following review examines all changes from the first World Health Organization (WHO) Classification of salivary gland pathologies from 1972 to fifth edition from 2022. Possible developments in the diagnosis and classification of salivary gland pathology are also presented. RESULTS The current WHO classification is the fifth edition. With the development of new diagnostic methods, based on genetic alterations, it provides insight into the molecular basis of lesions. This has resulted in the evolution of classification, introduction of new entities and reclassification of existing ones. CONCLUSIONS Genetic alterations will become increasingly more significant in the identification of salivary gland pathologies in the future. These alterations will be helpful as prognostic and predictive biomarkers, and may also serve as targets for anti-cancer therapies.
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Affiliation(s)
- Michał Żurek
- Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, 1a Banacha Str, 02-097, Warsaw, Poland.
- Doctoral School, Medical University of Warsaw, 61 Żwirki I Wigury Str, 02-091, Warsaw, Poland.
| | - Łukasz Fus
- Department of Pathology, Medical University of Warsaw, 7 Pawińskiego Str, 02-004, Warsaw, Poland
| | - Kazimierz Niemczyk
- Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, 1a Banacha Str, 02-097, Warsaw, Poland
| | - Anna Rzepakowska
- Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, 1a Banacha Str, 02-097, Warsaw, Poland
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Chen CN, Yang TL. Application of ultrasound in distinguishing the incipient microtumor from inherent lymph nodes of the parotid glands. J Formos Med Assoc 2023; 122:994-1000. [PMID: 37391337 DOI: 10.1016/j.jfma.2023.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/18/2023] [Accepted: 05/12/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND Parotid microtumors (size ≤ 1 cm) pose a significant clinical challenge due to their malignant potential and risks associated with surgery. It is imperative to explore the diagnostic workflow that incorporates ultrasound (US) in order to make appropriate clinical decisions with minimal invasiveness. METHODS The patients receiving both US and ultrasound-guided fine needle aspiration (USFNA) for the parotid microtumors in a medical center were retrospectively recruited. The ultrasonic features, cytology of USFNA, and final surgical pathology were analyzed to differentiate the tumor origins and their malignant potential. RESULTS From August 2009 to March 2016, a total of 92 patients were enrolled in the study. The short axis, long-to-short axis ratio, and presence of an echogenic hilum were found to be significantly useful in distinguishing lymphoid tissue origin from salivary gland origin, which was confirmed by USFNA. An irregular border was predictive for malignant parotid microtumors from both origins. Intra-tumoral heterogeneity was also identified as a significant feature associated with malignant lymph nodes. USFNA was able to confirm all malignant lymph nodes, but it had a false negative rate of 8.5% in parotid microtumors of salivary gland origin. Based on the analysis of US and USFNA results, a diagnostic workflow for parotid microtumors was proposed. CONCLUSION US and USFNA can be helpful in classifying the origins of parotid microtumors. US-FNA carries the risk of producing false negative results specifically for microtumors originating from salivary glands, but not lymphoid tissue. The diagnostic workflow, which incorporates both US and USFNA, assists in determining the clinical decision for diagnosing and managing parotid microtumors.
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Affiliation(s)
- Chun-Nan Chen
- Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Tsung-Lin Yang
- Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan; Research Center for Developmental Biology and Regenerative Medicine, National Taiwan University, Taipei, Taiwan; Center of Industry-Academia Cooperation, National Taiwan University, Taiwan.
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Zhao F, Huang X, He J, Li J, Li Q, Wei F, Chen H, Su J. A nomogram for distinguishing benign and malignant parotid gland tumors using clinical data and preoperative blood markers: development and validation. J Cancer Res Clin Oncol 2023; 149:11719-11733. [PMID: 37402966 DOI: 10.1007/s00432-023-05032-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 06/27/2023] [Indexed: 07/06/2023]
Abstract
PURPOSE This study aimed to construct and validate a nomogram that incorporated clinical data and preoperative blood markers to differentiate BPGTs from MPGTs more efficiently and at low cost. METHODS We retrospectively analyzed patients who underwent parotidectomy and histopathological diagnosis at the First Affiliated Hospital of Guangxi Medical University from January 2013 to June 2022. Subjects were randomly divided into training and validation sets with a 7:3 ratio. In the training set, the least absolute shrinkage and selection operator (LASSO) regression analysis was performed to select the most relevant features from 19 variables and built a nomogram using logistic regression. We evaluated the model's performance using receiver-operating characteristic (ROC) curves, calibration curves, clinical decision curve analysis (DCA), and clinical impact curve analysis (CICA). RESULTS The final sample consisted of 644 patients, of whom 108 (16.77%) had MPGTs. The nomogram included four features: current smoking status, pain/tenderness, peripheral facial paralysis, and lymphocyte-to-monocyte ratio (LMR). The optimal cut-off value for the nomogram was 0.17. The areas under the ROC curves (AUCs) of the nomogram were 0.748 (95% confidence interval [CI] = 0.689-0.807) and 0.754 (95% CI = 0.636-0.872) in the training and validation sets, respectively. The nomogram also showed good calibration, high accuracy, moderate sensitivity, and acceptable specificity in both sets. The DCA and CICA demonstrated that the nomogram had significant net benefits for a wide range of threshold probabilities (0.06-0.88 for the training set; 0.06-0.57 and 0.73-0.95 for the validation set). CONCLUSION The nomogram based on clinical characteristics and preoperative blood markers was a reliable tool for discriminating BPGTs from MPGTs preoperatively.
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Affiliation(s)
- Feng Zhao
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiaoying Huang
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Department of Otolaryngology, The Guangxi International Zhuang Medicine Hospital, Nanning, China
| | - Junkun He
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jiangmiao Li
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Qiyun Li
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Fangyu Wei
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Huiying Chen
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jiping Su
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
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Yıldız E, Kuzu S, Günebakan Ç, Özdemir M, Bucak A, Kahveci OK. Is the combined use of ultrasonography (USG) and fine needle aspiration biopsy (FNAB) safe in parotis masses? Retrospective comprehensive comparison of 123 cases. Ir J Med Sci 2023; 192:1861-1865. [PMID: 36097318 DOI: 10.1007/s11845-022-03155-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/06/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The purpose of the study was to compare final pathology results with ultrasonography (USI) and fine needle aspiration biopsy (FNAB) results in parotis masses. METHODS A total of 123 patients with primary parotis mass who applied to our center between 2010 and 2020 were selected for the study. Among these, 100 patients with preoperative USI, preoperative FNAB, and postoperative final pathology were included in the study. USI, FNAB, pathology results, surgery types, and demographic characteristics of the patients were analyzed. RESULTS According to the postoperative final pathology, preoperative USI sensitivity was found to be 100%, specificity was 55, positive predictive value was 84.31%, negative predictive value was 100%, and accuracy was 86.89%. Preoperative FNAB had a sensitivity of 85.7%, a specificity of 92.1%, a positive predictive value of 82.1%, a negative predictive value of 90.2%, and a diagnostic accuracy of 89.3%, according to the postoperative final pathology. CONCLUSION Preoperative USI and preoperative FNAB are very valuable diagnostic tools in the evaluation of parotis lesions. When used together, they provide highly accurate and important data for the surgeon.
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Affiliation(s)
- Erkan Yıldız
- Department of Otolaryngology, Healty Science University Hospital, Afyonkarahisar, Turkey.
| | - Selçuk Kuzu
- Department of Otolaryngology, Healty Science University Hospital, Afyonkarahisar, Turkey
| | - Çağlar Günebakan
- Department of Otolaryngology, Healty Science University Hospital, Afyonkarahisar, Turkey
| | - Murat Özdemir
- Department of Otolaryngology, Healty Science University Hospital, Afyonkarahisar, Turkey
| | - Abdulkadir Bucak
- Department of Otolaryngology, Healty Science University Hospital, Afyonkarahisar, Turkey
| | - Orhan Kemal Kahveci
- Department of Otolaryngology, Healty Science University Hospital, Afyonkarahisar, Turkey
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8
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[Indications for fine-needle aspiration and core needle biopsy for diagnosis of salivary gland tumors]. HNO 2023; 71:154-163. [PMID: 35376970 DOI: 10.1007/s00106-022-01160-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Salivary gland malignancies are rare neoplasms of the head and neck area. Preoperative clinical and imaging assessment of salivary gland masses is challenging. However, preoperative identification of malignancy is crucial for further treatment and for the course of the disease. OBJECTIVE This article presents the advantages and disadvantages of fine-needle aspiration cytology (FNAC) and core needle biopsy (CNB). Additionally, the sensitivity and specificity of both methods for predicting malignancy were analyzed. Furthermore, it is discussed which procedure is suitable for the diagnostic work-up of salivary gland tumors. MATERIALS AND METHODS This current article summarizes important and recent studies in the field of the diagnostic work-up for salivary gland lesions, with discussion of original articles, metanalyses, and systematic reviews concerning FNAC and CNB. RESULTS The sensitivity and specificity of the predictive ability of FNAC for malignancy is described at between 70.0-80.0% and 87.5-97.9%. The pooled sensitivity and specificity for CNB were 92.0-98.0% and 95.0-100.0%, respectively. Tumor cell seeding or facial nerve palsy are very rare complications of both procedures. CONCLUSION If malignancy is suspected based on clinical examination or imaging, FNAC or CNB should be performed. FNAC is easy to perform; however, an onsite cytologist is necessary. CNB has a higher sensitivity for routine diagnosis of malignancy; tumor typing and grading is facilitated by preserving the histological architecture. In conclusion, CNB is the procedure of choice in the diagnostic work-up for suspected malignant salivary gland tumors.
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Liu X, Pan Y, Zhang X, Sha Y, Wang S, Li H, Liu J. A Deep Learning Model for Classification of Parotid Neoplasms Based on Multimodal Magnetic Resonance Image Sequences. Laryngoscope 2023; 133:327-335. [PMID: 35575610 PMCID: PMC10083903 DOI: 10.1002/lary.30154] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/17/2022] [Accepted: 04/12/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To design a deep learning model based on multimodal magnetic resonance image (MRI) sequences for automatic parotid neoplasm classification, and to improve the diagnostic decision-making in clinical settings. METHODS First, multimodal MRI sequences were collected from 266 patients with parotid neoplasms, and an artificial intelligence (AI)-based deep learning model was designed from scratch, combining the image classification network of Resnet and the Transformer network of Natural language processing. Second, the effectiveness of the deep learning model was improved through the multi-modality fusion of MRI sequences, and the fusion strategy of various MRI sequences was optimized. In addition, we compared the effectiveness of the model in the parotid neoplasm classification with experienced radiologists. RESULTS The deep learning model delivered reliable outcomes in differentiating benign and malignant parotid neoplasms. The model, which was trained by the fusion of T2-weighted, postcontrast T1-weighted, and diffusion-weighted imaging (b = 1000 s/mm2 ), produced the best result, with an accuracy score of 0.85, an area under the receiver operator characteristic (ROC) curve of 0.96, a sensitivity score of 0.90, and a specificity score of 0.84. In addition, the multi-modal paradigm exhibited reliable outcomes in diagnosing the pleomorphic adenoma and the Warthin tumor, but not in the identification of the basal cell adenoma. CONCLUSION An accurate and efficient AI based classification model was produced to classify parotid neoplasms, resulting from the fusion of multimodal MRI sequences. The effectiveness certainly outperformed the model with single MRI images or single MRI sequences as input, and potentially, experienced radiologists. LEVEL OF EVIDENCE 3 Laryngoscope, 133:327-335, 2023.
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Affiliation(s)
- Xu Liu
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.,ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, NHC Key Laboratory of Hearing Medicine (Fudan University), Shanghai, China
| | - Yucheng Pan
- Department of Radiology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Xin Zhang
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.,ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, NHC Key Laboratory of Hearing Medicine (Fudan University), Shanghai, China
| | - Yongfang Sha
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.,ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, NHC Key Laboratory of Hearing Medicine (Fudan University), Shanghai, China
| | - Shihui Wang
- Lab of Sensing and Computing, Shanghai Advanced Research Institute, Chinese Academy of Sciences, Shanghai, China
| | - Hongzhe Li
- Research Service, VA Loma Linda Healthcare System, Loma Linda, California, U.S.A.,Department of Otolaryngology-Head and Neck Surgery, Loma Linda University School of Medicine, Loma Linda, California, U.S.A
| | - Jianping Liu
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.,ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, NHC Key Laboratory of Hearing Medicine (Fudan University), Shanghai, China
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10
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Taniuchi M, Terada T, Kawata R. Fine-Needle Aspiration Cytology for Parotid Tumors. LIFE (BASEL, SWITZERLAND) 2022; 12:life12111897. [PMID: 36431032 PMCID: PMC9693155 DOI: 10.3390/life12111897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/12/2022] [Accepted: 11/14/2022] [Indexed: 11/17/2022]
Abstract
Fine-needle aspiration (FNA) cytology is widely used in clinical practice as a simple and minimally invasive test for parotid tumors that allows for preoperative estimation of benignancy and malignancy, histological type, and malignancy grade and can be performed on an outpatient basis. In recent years, cell blocks prepared with core needle biopsy (CNB) and liquid-based cytology (LBC) have increased the reliability of immunostaining and molecular biological testing, leading to improved diagnostic accuracy. In 2018, the Milan System for Reporting Salivary Gland Cytology was introduced, but it does not include malignancy grade or histological type, so we proposed the Osaka Medical College classification as a more clinically based cell classification that includes both types of information, and we have reported on its usefulness. This review gives an overview of the history and use of FNA and describes CNB and LBC and the two classification systems.
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11
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Russell MD, Orloff LA. Ultrasonography of the thyroid, parathyroids, and beyond. HNO 2022; 70:333-344. [PMID: 35364686 PMCID: PMC8974803 DOI: 10.1007/s00106-022-01162-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2022] [Indexed: 11/29/2022]
Abstract
Background Ultrasonography has become an essential tool for the evaluation and management of thyroid and parathyroid diseases. Its applications extend beyond neck endocrine conditions to a multitude of pathologies within the head and neck region. Objectives Our study aimed to: (1) provide a broad review of neck ultrasonography and key findings in neck endocrine diseases; (2) support skilled performance office-based diagnostic ultrasonography and its varied applications. Materials and methods A review of the current literature was supplemented with clinical examples of key ultrasonographic findings. Results Current applications and key findings of ultrasonography in the diagnosis and management of neck endocrine conditions are reviewed. Conclusion Ultrasonography is a fundamental component in the evaluation and management of neck endocrine diseases. The reader is encouraged to use this review to enhance office-based performance and application of ultrasonography. Video online The online version of this article contains 11 additional videos. They are provided to illustrate some of the dynamic aspects of US performance. The article and the videos are available online (10.1007/s00106-022-01162-0). The videos can be found in the article back matter as “Electronic Supplementary Material”.
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Affiliation(s)
- Marika D Russell
- Department of Otolaryngology-Head and Neck Surgery, University of California, 2233 Post Street, 3rd Floor, San Francisco, CA, USA.
| | - Lisa A Orloff
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
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