1160 AJR:196, May 2011 shown that sonographically guided FNAB is useful in this setting, there have been few large studies describing this procedure for the assessment of salivary gland lesions [4]. The purpose of this study was to deter- mine the accuracy of sonographically guid- ed FNAB for the diagnosis of major salivary gland tumors by comparing the biopsy re- sults with the final pathologic diagnoses of 245 major salivary gland masses after surgi- cal excision. Materials and Methods We enrolled a total of 245 major salivary gland masses from 244 patients who had undergone a sonographically guided FNAB followed by surgi- cal excision between January 2006 and June 2009. The cytologic diagnoses of these masses were ret- rospectively reviewed. The patients included 102 males and 142 females and ranged in age from 12 to 83 years (mean age, 47 years). The aspirates Sonographically Guided Fine- Needle Aspiration Biopsy of Major Salivary Gland Masses: A Review of 245 Cases Hee Woo Cho 1 Jinna Kim 1 Junjeong Choi 2 Hyun Seok Choi 1 Eun Soo Kim 1 Se-Heon Kim 3 Eun Chang Choi 3 Cho HW, Kim J, Choi J, et al. 1 Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, Korea. Address correspondence to J. Kim (jinna@yuhs.ac). 2 Department of Pathology, Yonsei University College of Medicine, Seoul, Korea. 3 Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea. Neuroradiology/Head and Neck Imaging • Original Research AJR 2011; 196:1160–1163 0361–803X/11/1965–1160 © American Roentgen Ray Society B ecause surgery is ultimately indi- cated for both benign and malig- nant salivary gland neoplasms, the preoperative differentiation of a benign tumor from a malignant tumor enables the surgeon to select the appropriate operative procedure and allows the patient to be informed of the nature of the disease and the treatment options before surgery [1–3]. Fine-needle aspiration biopsy (FNAB) is a fast, safe, and effective diagnostic technique that can be performed as an outpatient pro- cedure for the evaluation of major salivary gland masses. In addition, because sonog- raphy can characterize salivary gland mass- es and identify accurate needle placement during the biopsy, sonographically guided FNAB of salivary gland masses is known to be more accurate than a biopsy performed via direct percutaneous puncture [4, 5]. However, although many investigators have Keywords: fine-needle aspiration biopsy, head and neck imaging, salivary gland, salivary gland mass, sonography DOI:10.2214/AJR.10.4256 Received January 7, 2010; accepted after revision September 23, 2010. OBJECTIVE. The purpose of this study was to determine the diagnostic accuracy of sonographically guided fine-needle aspiration biopsy (FNAB) for major salivary gland tu- mors by comparing the biopsy results for 245 salivary gland masses with the final pathologic diagnosis after surgical excision. MATERIALS AND METHODS. This retrospective study included a total of 245 major salivary gland tumors from 244 patients who had undergone sonographically guided FNAB followed by surgical excision. To evaluate the diagnostic accuracy of FNAB, we compared the histopathologic diagnoses with the preoperative cytology results obtained from FNAB. False-negative diagnoses based on the FNAB results were reviewed. RESULTS. Two hundred fifteen aspirates (87.8%) yielded adequate cytology results. In the 215 masses from which adequate material was obtained and an unequivocal cytology re- sult was obtained, the overall sensitivity, specificity, and accuracy of sonographically guided FNAB in differentiating malignant from benign tumors was 75.7%, 100%, and 95.8%, re- spectively. The false-negative diagnostic rate was 4.2% (9/215), but there were no false-pos- itive diagnoses of malignancy. Among the 47 malignancies, only 28 cases (59.6%) were de- tected preoperatively by FNAB. CONCLUSION. For the preoperative evaluation of major salivary gland tumors, sono- graphically guided FNAB is feasible for distinguishing between benign and malignant sali- vary gland tumors in the subset of patients with satisfactory cytologic diagnoses. However, negative or nondiagnostic cytologic results cannot always guarantee benignity of the final di- agnosis, and therefore careful consideration of the sonographic features and cytologic results is necessary to avoid false reassurance. Cho et al. Sonographically Guided FNAB of Salivary Gland Masses Neuroradiology/Head and Neck Imaging Original Research Downloaded from www.ajronline.org by 52.73.204.196 on 05/16/22 from IP address 52.73.204.196. Copyright ARRS. For personal use only; all rights reserved