Background: Parotid gland tumors constitute a significant proportion of head and neck neoplasms, and accurate non-invasive differentiation is essential for appropriate clinical management. Recent advances in ultrasound techniques, including shear-wave elastography (SWE), have shown promising diagnostic potential. Aim: To evaluate the diagnostic performance of long-to-short axis ratio (L/S) and shear-wave velocity (SWV) values obtained by virtual touch imaging quantification (VTIQ) in differentiating pleomorphic adenoma (PA), Warthin tumor (WT), and malignant tumors (MT) of the parotid gland. Materials and Methods: This study included 66 parotid masses from 63 patients who underwent conventional ultrasound and SWE examinations. B-mode features, Doppler vascular patterns, L/S ratios, and SWV values were recorded and compared with histopathological findings. Receiver operating characteristic (ROC) analysis was performed to determine optimal cutoff values, sensitivity, and specificity. Results: The cutoff value for differentiating WT and PA was 1.57 for the L/S ratio (sensitivity: 83.33%, specificity: 88.46%, p < 0.001). For distinguishing MT from PA, the L/S cutoff was 1.68 (sensitivity: 50.00%, specificity: 96.15%, p < 0.001). The optimal SWV cutoff for WT and PA differentiation was 5.02 m/s (sensitivity: 91.67%, specificity: 73.08%, p < 0.001), while for MT and PA differentiation, it was 6.30 m/s (sensitivity: 84.62%, specificity: 62.50%, p < 0.001). Conclusion: The combined use of L/S ratio and SWV values obtained by VTIQ provides a reliable and non-invasive diagnostic approach for differentiating parotid gland tumors and may help reduce unnecessary biopsies.
Demirci et al. (Wed,) studied this question.