Study Type
Study Type
Study Objective(Purpose of Study)
Study Objective(Purpose of Study)
Study Results
Study Results
Study Quality
Study Quality
1. Choi JW, Kim SS, Kim EY, Heran M. Peripheral T-cell lymphoma in the neck: CT findings of lymph node involvement. AJNR Am J Neuroradiol. 2006;27(5):1079-1082. Review/Other-Dx 27 patients Retrospective study to describe CT findings of lymph nodes of the neck involved in peripheral T-cell lymphomas. Nodal necrosis and ill-defined margin were seen in 11/27 (41%) and 19/27 (70%), respectively. Heterogeneous enhancement of enlarged lymph nodes was noted on CT images in 19/27 (70%) of patients. Homogeneous enhancement without ill-defined margin and/or nodal necrosis was only seen in 6/27 patients (22%). 4
2. Kim HJ, Lee HK, Seo JJ, et al. MR imaging of solitary fibrous tumors in the head and neck. Korean J Radiol. 2005;6(3):136-142. Review/Other-Dx 6 patients Retrospective review to determine the MRI features of solitary fibrous tumor in the intracranial and extra cranial head and neck regions. Solitary fibrous tumor has nonspecific imaging features. Study recommends solitary fibrous tumor in the differential diagnosis of masses involving the intracranial and extra cranial head and neck regions. 4
3. Kim ST, Kim HJ, Park SW, Baek CH, Byun HS, Kim YM. Nodular fasciitis in the head and neck: CT and MR imaging findings. AJNR Am J Neuroradiol. 2005;26(10):2617-2623. Review/Other-Dx 7 patients Retrospective review to describe CT and MRI findings of nodular fasciitis occurring in the head and neck region. Lesions appeared as a discrete mass on imaging, with range of 1.0 cm-4.6 cm in diameter (mean, 2.2 cm). Authors suggest nodular fasciitis should be included in differential diagnosis, when one sees a head and neck mass with a superficial location and moderate to marked enhancement on CT and MRI. 4
4. Lanka B, Turner M, Orton C, Carrington BM. Cross-sectional imaging in non-melanoma skin cancer of the head and neck. Clin Radiol. 2005;60(8):869-877. Review/Other-Dx 33 patients Retrospective study to compare MRI and CT findings with histopathology to determine accuracy of MRI or CT in detecting local recurrence in patients with neck non-melanoma skin cancers. Imaging accuracy for identifying recurrent tumor was 96% (24/25 patients). Authors conclude that cross-sectional is accurate in identifying tumor extent and local recurrence. Patient outcome is based on extent of disease and invasion of deeper structures. 4
5. Smith JL, 2nd, Hsu JM, Chang J. Predicting deep neck space abscess using computed tomography. Am J Otolaryngol. 2006;27(4):244-247. Observational-Dx 32 patients Retrospective analysis to determine measures that could increase the PPV of CT in diagnosing deep neck space infections. Although CT with contrast is useful in the diagnosis and management of deep neck space infections, the decision for surgical drainage of an abscess should be made clinically. A negative exploration rate of nearly 25% despite careful selection criteria should be expected. 4
6. Tanaka T, Morimoto Y, Takano H, et al. Three-dimensional identification of hemangiomas and feeding arteries in the head and neck region using combined phase-contrast MR angiography and fast asymmetric spin-echo sequences. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100(5):609-613. Review/Other-Dx 3 patients To evaluate a proposed technique for the 3D detection of hemangiomas and feeding arteries in the head and neck using phase-contrast MRA plus fast asymmetric spin-echo sequences. In all patients, the 3D presence of the hemangiomas and the feeding arteries were well defined in images created by the proposed technique. 4
7. Giannitto C, Esposito AA, Casiraghi E, Biondetti PR. Epidemiological profile of non-traumatic emergencies of the neck in CT imaging: our experience. Radiol Med. 2014;119(10):784-789. Review/Other-Dx 143 patients To collect information on the incidence and distribution of acute, non-traumatic conditions of the neck at our emergency radiology department and to review the literature about this topic. Computed tomography examination was positive in 125 out of 143 patients (87.4%), 74 men and 51 women, with an average age of 51.1 years, aged between 10 and 90 years. We found 79 inflammatory/infectious conditions (63.2% of positive cases, 55.2% of total cases), 46 men and 33 women, with an average age of 47 years. Computed tomography revealed 26 newly found tumours (20.8/18.2%), 19 men and 7 women, with an average age of 68.5 years, aged between 49 and 97 years. In 20 cases, 9 men and 11 women, with an average age of 57.3 years, aged between 21 and 90 years, we diagnosed other acute conditions: six cases of foreign body ingestion (4.8/4.2%), five benign swellings (4/3.5%), five cases of vascular disorders (4/3.5%), and four cases of oedema of the larynx (3.2/2.8 %). 4
8. Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. [Review]. Thyroid. 26(1):1-133, 2016 Jan. Review/Other-Dx N/A To inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid nodules and differentiated thyroid cancer. The revised guidelines for the management of thyroid nodules include recommendations regarding initial evaluation, clinical and ultrasound criteria for fine-needle aspiration biopsy, interpretation of fine-needle aspiration biopsy results, use of molecular markers, and management of benign thyroid nodules. Recommendations regarding the initial management of thyroid cancer include those relating to screening for thyroid cancer, staging and risk assessment, surgical management, radioiodine remnant ablation and therapy, and thyrotropin suppression therapy using levothyroxine. Recommendations related to long-term management of differentiated thyroid cancer include those related to surveillance for recurrent disease using imaging and serum thyroglobulin, thyroid hormone therapy, management of recurrent and metastatic disease, consideration for clinical trials and targeted therapy, as well as directions for future research. 4
9. Kataoka M, Ueda H, Koyama T, et al. Contrast-enhanced volumetric interpolated breath-hold examination compared with spin-echo T1-weighted imaging of head and neck tumors. AJR Am J Roentgenol. 2005;184(1):313-319. Observational-Dx 33 patients; 3 observers Prospective study to compare volumetric interpolated breath-hold examination images with conventional post-contrast spin-echo T1-weighted images in the assessment of HNT. For quantitative assessment, no significant difference was detected between the two sequences. For qualitative assessments, the degree of image degradation by artifacts was smaller for volumetric interpolated breath-hold examination images than for spin-echo T1-weighted images (P=0.029). Authors conclude that the post-contrast volumetric interpolated breath-hold examination sequence is a good alternative to post-contrast spin-echo T1-weighted imaging. 2
10. Padovani RP, Kasamatsu TS, Nakabashi CC, et al. One month is sufficient for urinary iodine to return to its baseline value after the use of water-soluble iodinated contrast agents in post-thyroidectomy patients requiring radioiodine therapy. Thyroid. 22(9):926-30, 2012 Sep. Observational-Dx 25 patients To evaluate the period required for urinary iodine (UI) levels to return to baseline values and to compare UI samples collected by 24U or urinary sample (sU) in the follow-up of differentiated thyroid cancer (DTC) patients (treated with total thyroidectomy and radioiodine) who have employed computed tomography (CT) using iodinated contrast agents (ICA) for evaluation of metastases. Baseline median UI levels were 21.8 mug/dL for 24U and 26 mug/dL for sU. One week after ICA, UI median levels were very high for all patients, 800 mug/dL. One month after ICA, however, UI median levels returned to baseline in all patients, 19.0 mug/dL for 24U and 20 mug/dL for sU. Although the values of median UI obtained from sU and 24U samples were signicantly different, we observed a significant correlation between samples collected in 24U and sU in all evaluated periods. 3
11. Kirsch C, Dellacerra G. Increasing Incidence and Imaging in Pediatric Head and Neck Cancer and Role of the Human Papilloma Virus and Epstein–Barr Virus. Journal of Pediatric Neuroradiology. 2016;05(03):221-228. Review/Other-Dx N/A To review the viral oncogenic properties of HPV and Epstein–Barr virus, what the biomarker p16 represents, and the salient clinical and radiographic features of tumors associated with these viruses. No results stated in abstract. 4
12. Sidell D, Nabili V, Lai C, Cheung G, Kirsch C, Abemayor E. Pediatric squamous cell carcinoma: Case report and literature review. Laryngoscope. 2009;119(8):1538-1541. Review/Other-Dx 1 case report To describe a rare pediatric malignancy and discuss the clinical, diagnostic, and therapeutic differences between squamous cell carcinoma (SCC) of the adult and pediatric population. This case report presents a 6-year-old male with a 2-month history of an enlarging oral lesion. The patient denied dysphagia, pain, weight loss, bleeding, or loosening of the teeth. Biopsy demonstrated invasive, well-differentiated, exophytic squamous cell carcinoma with perineural and angiolymphatic invasion. Computed tomography and magnetic resonance imaging demonstrated a 2.7 x 3.0 cm poorly marginated infiltrative mass involving the gingival aspect of the superior alveolar ridge and the adjacent bony marrow, primarily to the right of midline. Multiple small subcentimeter lymph nodes were also identified in the bilateral level II to V posterior cervical triangles bilaterally. 4
13. Chuang SY, Lin HT, Wen YS, Hsu FJ. Pitfalls of CT for deep neck abscess imaging assessment: a retrospective review of 162 cases. B-ENT. 2013;9(1):45-52. Observational-Dx 162 patients To investigate the diagnostic value of contrast-enhanced computed tomography (CT) for the prediction of deep neck abscesses in different deep neck spaces and to evaluate the false-positive results. The overall PPV for the prediction of deep neck abscess with contrast-enhanced CT was 79.6%. The PPV was 91.3% when more than one deep neck space was involved but only 50.0% in patients with isolated retropharyngeal abscesses. In the false-positive group, cellulitis was the most common final result, followed by cystic degeneration of cervical metastases. Five specimens taken intra-operatively revealed malignancy and four of these were not infected. 3
14. Pynnonen MA, Gillespie MB, Roman B, et al. Clinical Practice Guideline: Evaluation of the Neck Mass in Adults Executive Summary. Otolaryngol Head Neck Surg. 2017;157(3):355-371. Review/Other-Dx N/A To provide Clinical Practice Guidelines for Neck Mass in Adults. No results stated in abstract. 4
15. American College of Radiology. ACR Appropriateness Criteria®: Thyroid Disease. Available at: Review/Other-Dx N/A Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for thyroid disease. No abstract available. 4
16. Expert Panel on Neurologic Imaging:, Salmela MB, Mortazavi S, et al. ACR Appropriateness Criteria Cerebrovascular Disease. J. Am. Coll. Radiol.. 14(5S):S34-S61, 2017 May. Review/Other-Dx N/A Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for cerebrovascular disease. No results stated in abstract. 4
17. Kessler MM, Moussa M, Bykowski J, et al. ACR Appropriateness Criteria(R) Tinnitus. J Am Coll Radiol. 2017;14(11S):S584-S591. Review/Other-Dx N/A Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for tinnitus. No results stated in abstract. 4
18. Bykowski J, Aulino JM, Berger KL, et al. ACR Appropriateness Criteria(R) Plexopathy. J Am Coll Radiol. 2017;14(5S):S225-S233. Review/Other-Dx N/A Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for plexopathy. No results stated in abstract. 4
19. NCCN Clinical Practice Guidelines in Oncology. Head and Neck Cancers. Version 2.2017.  Available at: Review/Other-Dx N/A To provide Clinical Practice Guidelines in Oncology No results stated in abstract. 4
20. Gamss C, Gupta A, Chazen JL, Phillips CD. Imaging evaluation of the suprahyoid neck. Radiol Clin North Am. 2015;53(1):133-144. Review/Other-Dx N/A To emphasize imaging considerations for the PMS, PPS, MS, PS, and CS. The No results stated in abstract. 4
21. Wang B, Gao BL, Xu GP, Xiang C. Images of deep neck space infection and the clinical significance. Acta Radiol. 2014;55(8):945-951. Observational-Dx 28 patients To investigate the images of deep neck space infection of phlegmon and abscess and the role of imaging examination in correct localization and treatment. All 28 patients were confirmed by CT and/or MRI to have deep neck infection, with 11 cases in the retropharyngeal space, five in the parapharyngeal space, four in the masseteric space, and eight in multiple spaces. Thirteen cases had abscesses that were successfully treated with incision and drainage under CT guidance in combination with large doses of antibiotics, and 15 had phlegmon managed with large doses of antibiotics. Followed up for 5-20 months, all patients recovered completely. Two patients were confirmed by imaging examination to have retropharyngeal infection spreading to the superior mediastinum with abscess formation and another two patients had multiple space infection because inappropriate puncture or incision for drainage without imaging guidance in these patients caused the spread of infection. Clinical diagnosis was not accurate with only 12 patients (42.9%) being correctly diagnosed of the exact deep neck space involved before imaging confirmation. CT and/or MRI made the correct diagnosis in all 28 patients. CT and/or MRI also directly changed the treatment plan in seven patients and contributed to the recovery of these patients. 3
22. Bartz BH, Case IC, Srinivasan A, Mukherji SK. Delayed MDCT imaging results in increased enhancement in patients with head and neck neoplasms. J Comput Assist Tomogr. 2006;30(6):972-974. Observational-Dx 37 patients To assess the impact of performing delayed imaging compared with immediate imaging on tumor enhancement using MDCT. Mean enhancement was 68.3 +/- 21.0 HU and 91.4 +/- 27.4 HU (n=37) for immediate and delayed imaging groups, respectively. The mean difference between the initial and delayed enhancement was 23.1 HU (P<0.01). Delayed imaging technique led to a statistically significant increase in enhancement relative to immediate imaging. 3
23. Fujita A, Buch K, Truong MT, et al. Imaging characteristics of metastatic nodes and outcomes by HPV status in head and neck cancers. Laryngoscope. 2016;126(2):392-398. Observational-Dx 139 patients To investigate the imaging characteristics of nodal metastasis by human papillomavirus (HPV) status in head and neck squamous cell carcinoma (HNSCC) and to clarify whether those findings influence the outcomes. Eighty-eight patients with nodal metastasis were identified and outcome information was available for 78 patients. Nodal metastasis was significantly more common in HPV-positive patients compared to HPV-negative patients (75% vs. 54%, P = 0.009). HPV-positive patients showed a higher prevalence of extracapsular spread (ECS) compared to HPV-negative patients (77% vs. 56%, P = 0.041). The prevalence of disease recurrence was more common in HPV-negative patients (67% vs. 13%, P < 0.0001), and it was independent of the presence of ECS in nodal metastasis. 2
24. Goldenberg D, Begum S, Westra WH, et al. Cystic lymph node metastasis in patients with head and neck cancer: An HPV-associated phenomenon. Head Neck. 2008;30(7):898-903. Observational-Dx 20 patients To better elucidate the entity of cystic lymph node metastasis as a feature of a subset of head and neck squamous cell cancer. One hundred neck dissections were reviewed and 20 had cystic nodes. Seventeen of these patients had primary tumors arising in the palatine or lingual tonsil. Three were "unknown primary." human papillomavirus (HPV) Deoxyribo nucleic acid (DNA) was present in 11 of 13 patients with cystic metastases with tissue available for analysis (87%). No HPV DNA was identified in tumor from 21 patients with solid nodal metastasis (p <.0001). 3
25. Eisenmenger LB, Wiggins RH, 3rd. Imaging of head and neck lymph nodes. Radiol Clin North Am. 2015;53(1):115-132. Review/Other-Dx N/A To review cervical lymph node anatomy as well as drainage pathways. No results stated in abstract. 4
26. Haynes J, Arnold KR, Aguirre-Oskins C, Chandra S. Evaluation of neck masses in adults. Am Fam Physician. 2015;91(10):698-706. Review/Other-Dx N/A To determine if the mass is malignant or benign; malignancies are more common in adult smokers older than 40 years. No results stated in abstract. 4
27. Pepper C, Pai I, Hay A, et al. Investigation strategy in the management of metastatic adenocarcinoma of unknown primary presenting as cervical lymphadenopathy. Acta Otolaryngol. 2014;134(8):838-842. Observational-Dx 41 cases To review investigation strategies for metastatic adenocarcinoma of unknown primary presenting as cervical lymphadenopathy, and to develop a management algorithm. This study examined 41 cases. CT of the neck, chest, abdomen and pelvis was the most useful initial investigation. It identified the primary tumour site in 16/28 cases (57%), detected the primary tumour and led to revision of the FNAC diagnosis in 1 case (2.4%), and was necessary for the final diagnosis of true unknown primary in 12 cases (29.3%). Targeted imaging was not helpful. 3
28. Kale HA, Prabhu AV, Sinelnikov A, Branstetter Bt. Fat: friend or foe? A review of fat-containing masses within the head and neck. Br J Radiol. 2016;89(1067):20150811. Review/Other-Dx N/A To review the various imaging presentations of common and some uncommon fat-containing lesions within the head and neck with potential pitfalls and mimics. No results stated in abstract. 4
29. Baldassari CM, Howell R, Amorn M, Budacki R, Choi S, Pena M. Complications in pediatric deep neck space abscesses. Otolaryngol Head Neck Surg. 2011;144(4):592-595. Observational-Dx 138 patients To determine the incidence and demographic profile of children who develop complications from deep neck space abscess. In the first 5 years of the study, 45 children met the inclusion criteria, whereas in the latter 5 years, 93 children were treated for abscesses. There were no differences between these cohorts in terms of age (P = .70), gender (P = .08), abscess site (P = .23), or rate of surgical intervention (P = .83). The total major complication rate was 9.4% (n = 13) with mediastinitis being the most frequent (n = 9) complication. The number of complications between the first (n = 3) and second (n = 10) groups was not significantly different (P = .55). The factors that predisposed patients to develop complications were younger age at presentation and retropharyngeal abscess location. Children with complications were more likely to have Staphylococcus aureus identified as the causative organism (P = .007). Only 1 of 4 children with methicillin-resistant S aureus had a complicated clinical course. 4
30. Favaretto N, Fasanaro E, Staffieri A, et al. Deep neck infections originating from the major salivary glands. Am J Otolaryngol. 2015;36(4):559-564. Observational-Dx 44 patients (group 1 ); 191 patients (group 2) To review our experience of the diagnosis and treatment of deep neck infections (DNIs) of salivary gland origin. In the present series, DNIs originating from a major salivary gland accounted for 19% of all cases of DNI of known origin. Patients with DNI of salivary gland origin were more likely to be elderly than those whose DNI originated from elsewhere (p=0.000). Our multivariate statistical model showed that comorbidities (p=0.051, statistical trend) and the need for surgical treatment (p=0.028) independently predicted long-term hospitalization for DNIs originating from a major salivary gland. 3
31. Nougue H, Le Maho AL, Boudiaf M, et al. Clinical and imaging factors associated with severe complications of cervical necrotizing fasciitis. Intensive Care Med. 2015;41(7):1256-1263. Observational-Dx 160 patients To estimate the incidence and factors associated with severe complications of Cervical necrotizing fasciitis (CNF). A cohort of 160 patients admitted for CNF was included. The following complications of CNF were found: bilateral extension of CNF (28%), internal jugular vein thrombosis (21%), descending necrotic effusion (14%), mediastinitis (24%), and mortality (4%); 53% had at least one complication, and 48% had at least one cervical complication. On the basis of a univariate analysis, the significant independent factors are odynophagia, dyspnea, oral glucocorticoids intake before admission, and pharyngeal source. Oral nonsteroidal anti-inflammatory drug intake before admission does not have any impact. The initial CNF complications increased both the duration of mechanical ventilation and the length of stay in the ICU. On the basis of a multivariate analysis, the independent factors for severe complications are pharyngeal CNF and oral glucocorticoid intake before admission. 3
32. Ibrahim M, Parmar H, Christodoulou E, Mukherji S. Raise the bar and lower the dose: current and future strategies for radiation dose reduction in head and neck imaging. AJNR Am J Neuroradiol. 2014;35(4):619-624. Review/Other-Dx N/A To describe current and future strategies for radiation dose reduction in head and neck imaging. No results stated in abstract. 4
33. American College of Radiology. ACR Practice Parameter for Performing and Interpreting Diagnostic Computed Tomography (CT). Available at: Review/Other-Dx N/A To provide guidelines for Performing and Interpreting Diagnostic Computed Tomography (CT) No results stated in abstract. 4
34. Kito S, Morimoto Y, Tanaka T, et al. Utility of diffusion-weighted images using fast asymmetric spin-echo sequences for detection of abscess formation in the head and neck region. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(2):231-238. Observational-Dx 10 control volunteers and 10 patients with phlegmon in the oral and maxillofacial regions. To evaluate the utility of new diffusion-weighted magnetic resonance images (DWI) using fast asymmetric spin-echo (FASE) sequences for the detection of abscess formation in patients with phlegmon in the oral and maxillofacial regions. Many kinds of tissues in the oral and maxillofacial regions were relatively well visualized in all subjects on FASE-DWI, but not well on EPI-DWI. Apparent diffusion coefficients calculated from FASE sequences in abscess areas of patients with phlegmon were significantly lower than those in abscess-free areas; however, apparent diffusion coefficients calculated from EPI were not significantly different due to prominent distortion in small sample size study. 3
35. Holzapfel K, Duetsch S, Fauser C, Eiber M, Rummeny EJ, Gaa J. Value of diffusion-weighted MR imaging in the differentiation between benign and malignant cervical lymph nodes. Eur J Radiol. 2009;72(3):381-387. Observational-Dx 35 patients To evaluate echo-planar diffusion-weighted magnetic resonance (MR) imaging (DWI) in the differentiation between benign and malignant cervical lymph nodes. Cervical lymph node enlargement was secondary to metastases from squamous cell carcinomas [n=25], non-Hodgkin's lymphoma [n=6], reactive lymphadenitis [n=20], cat scratch lymphadenitis [n=2] and sarcoidosis [n= 2]. The mean ADC values (x10(-3) mm(2)/s) were 0.78+/-0.09 for metastatic lymph nodes, 0.64+/-0.09 for lymphomatous nodes and 1.24+/-0.16 for benign cervical lymph nodes. ADC values of malignant lymph nodes were significantly lower than ADC values of benign lymph nodes. 94.3% of lesions were correctly classified as benign or malignant using a threshold ADC value of 1.02 x 10(-3) mm(2)/s. 3
36. Sumi M, Sakihama N, Sumi T, et al. Discrimination of metastatic cervical lymph nodes with diffusion-weighted MR imaging in patients with head and neck cancer. AJNR Am J Neuroradiol. 2003;24(8):1627-1634. Observational-Dx 25 metastatic nodes To determine whether the apparent diffusion coefficient (ADC) could discriminate metastatic nodes in the neck. The ADC was significantly greater in metastatic lymph nodes (0.410 +/- 0.105 x 10(-3) mm(2)/s, P <.01) than in benign lymphadenopathy (0.302 +/- 0.062 x 10(-3) mm(2)/s). Nodal lymphomas showed even lower levels of the ADC (0.223 +/- 0.056 x 10(-3) mm(2)/s). ADC criteria for metastatic nodes (>/= 0.400 x 10(-3) mm(2)/s) yielded a moderate negative predictive value (71%) and high positive predictive value (93%). Receiver operating characteristic analysis demonstrated that the criteria of abnormal signal intensity on T1- or T2-weighted images (A(z) = 0.8437 +/- 0.0230) and ADC (A(z) = 0.8440 +/- 0.0538) provided similar levels of diagnostic ability in differentiating metastatic nodes. The ADC from metastatic nodes from highly or moderately differentiated cancers (0.440 +/- 0.020 x 10(-3) mm(2)/s, P <.01) was significantly greater than that from poorly differentiated cancers (0.356 +/- 0.042 x 10(-3) mm(2)/s). 3
37. Noij DP, Martens RM, Marcus JT, et al. Intravoxel incoherent motion magnetic resonance imaging in head and neck cancer: A systematic review of the diagnostic and prognostic value. Oral Oncol. 2017;68:81-91. Review/Other-Dx 17 studies To determine the diagnostic and prognostic performance of Intravoxel incoherent motion (IVIM) in head and neck cancer (HNC) by performing a critical review of the literature. No results stated in abstract 4
38. Ashraf M, Biswas J, Jha J, et al. Clinical utility and prospective comparison of ultrasonography and computed tomography imaging in staging of neck metastases in head and neck squamous cell cancer in an Indian setup. Int J Clin Oncol. 2011;16(6):686-693. Observational-Dx 584 To compare the evaluation of lymph node metastases by ultrasonography (USG) and computed tomography (CT) in patients with squamous cell cancer of the head and neck region. Five hundred and eighty-four patients with squamous cell cancer of the head and neck were prospectively evaluated for the presence of cervical lymph node metastases. All patients underwent clinical examination (palpation), USG and CT imaging. Neck dissection was performed in all the patients, and the results of the preoperative evaluation were correlated with the surgical and histopathological findings. Metastases in neck nodes were identified in 148 patients by histopathological examination. Doppler USG correctly identified 136 node-positive patients (n = 148; sensitivity 91.8%, specificity 97%). CT imaging correctly identified 122 patients with metastatic lymph nodes (n = 148; sensitivity 83%, specificity 93%). Positive predictive values of USG and CT imaging were 95.6% and 91.3%, respectively, whereas the negative predictive values of these two imaging studies were 95.4% and 89.6%, respectively. 2
39. Jayachandran S, Sachdeva SK. Diagnostic accuracy of color doppler ultrasonography in evaluation of cervical lymph nodes in oral cancer patients. Indian J Dent Res. 2012;23(4):557-558. Observational-Dx 80 patients To assess the diagnostic accuracy of color doppler ultrasonography (CDUS) in differentiating metastatic from reactive lymph nodes in oral cancer patients. Sensitivity of CDUS by vascular flow pattern was 94.1%, specificity of 100%, with accuracy of 95.4% and by vascular indices the sensitivity was 81.4%, specificity of 100%, and accuracy of 85.5%, with statistically significant correlation.(P < 0.05) 3
40. Khanna R, Sharma AD, Khanna S, Kumar M, Shukla RC. Usefulness of ultrasonography for the evaluation of cervical lymphadenopathy. World J Surg Oncol. 2011;9:29. Observational-Dx 192 patients To evaluate the role of ultrasonography for differentiating cervical lymphadenopathy due to tuberculosis, metastasis and lymphoma. The most significant distinguishing feature was strong internal echoes seen in 84% of tubercular lymph nodes. This finding was found in only 11% of metastatic nodes and absent in lymphomatous nodes. The other findings such as L/S ratio, irregular margins, hypoechoic center, fusion tendency, peripheral halo and absent hilus were helpful in differentiating reactive from diseased nodes but showed considerable overlap in the 3 groups of tubercular, metastatic and lymphoma lymph nodes. 3
41. Ahuja AT, Ying M, Ho SY, et al. Ultrasound of malignant cervical lymph nodes. Cancer Imaging. 2008;8:48-56. Review/Other-Dx N/A Review evaluation of malignant cervical lymph nodes with US. Power Doppler US evaluates the vascular pattern of nodes and helps identify the malignant nodes. 4
42. Gronkiewicz JJ, Vade A. Cervical lymph node fine needle aspiration in patients with no history of malignancy. Ultrasound Q. 2013;29(4):323-326. Observational-Dx 24 patients To determine the utility of cervical lymph node fine needle aspiration (FNA) in patients with sonographically normal lymph nodes and without history of malignancy. The only sonographic characteristic with a significant association with lymph node malignancy was the absence of an echogenic hilus. No significant correlation was found between the clinical findings evaluated and the cervical lymph node benignity or malignancy. 3
43. Gupta A, Rahman K, Shahid M, et al. Sonographic assessment of cervical lymphadenopathy: role of high-resolution and color Doppler imaging. Head Neck. 2011;33(3):297-302. Observational-Dx 64 patients To study the role of high frequency ultrasound and color Doppler imaging in the diagnostic evaluation of patients with cervical lymphadenopathy. The results showed that malignant lymph nodes, especially metastatic nodes, are mostly accompanied with rounded shape, homogenous echotexture, peripheral vascularity, and significantly high RI. Among these sonographic findings, nodal shape (S/L ratio) and RI were more accurate for differentiating benign from malignant lymph nodes. Most of the malignant nodes had well-defined borders. Calcification, necrosis, posterior enhancement, matting, and hilar flow patterns were characteristically found in tubercular lymphadenitis. A combined ultrasound-guided and fine-needle aspiration (FNA) diagnosis had a high sensitivity (95.4%) and specificity (92.3) as compared with situations in which they were used alone. 2
44. Ryu KH, Lee KH, Ryu J, et al. Cervical Lymph Node Imaging Reporting and Data System for Ultrasound of Cervical Lymphadenopathy: A Pilot Study. AJR Am J Roentgenol. 2016;206(6):1286-1291. Observational-Dx 291 patients To compare ultrasound (US) and real-time elastography (RTE) features of benign and malignant cervical lymphadenopathies and propose a structured reporting system for lymph nodes. The imaging features that were significantly associated with malignant lymphadenopathy were round shape, noncircumscribed margin, hyperechogenicity, absence of hilum, gross necrosis, calcification, peripheral or mixed vascularity, high elasticity scores, and high level of strain ratio (p < 0.05). The fitted probability and risk of malignancy increased as the number of suspicious features increased. The risk of malignancy according to the Cervical Lymph Node Imaging Reporting and Data System categories was as follows: category 1, 3.3%; category 2, 10.9%; category 3, 26.7%; category 4, 51.8-74.4%; and category 5, 90.6-98.8%. An analysis of the overall interobserver agreement revealed that interobserver agreement was moderate to good. 2
45. Ying M, Bhatia KS, Lee YP, Yuen HY, Ahuja AT. Review of ultrasonography of malignant neck nodes: greyscale, Doppler, contrast enhancement and elastography. Cancer Imaging. 2013;13(4):658-669. Review/Other-Dx N/A To review the value of greyscale, Doppler and contrast-enhanced ultrasonography as well as elastography in the assessment of malignant nodes in the neck. No results stated in abstract. 4
46. Ying M, Ahuja A, Brook F. Accuracy of sonographic vascular features in differentiating different causes of cervical lymphadenopathy. Ultrasound Med Biol. 2004;30(4):441-447. Observational-Dx 270 patients Retrospective review to assess the accuracy of US vascular features in differentiating different causes of cervical lymphadenopathy. Vascular pattern with sensitivity of 88% for metastases and 67% for lymphoma was more useful. RI with 0.8 cut-off value was more accurate in distinguishing metastases (RI >0.8) from lymphoma (RI <0.8), with an accuracy of 65% and 75%, respectively. Displacement of vascularity was helpful to differentiate tuberculous nodes (accuracy: 67%) from reactive and lymphomatous nodes (accuracy: 100% and 95%, respectively), while PI with 1.5 cut-off helped the differentiation between tuberculosis (PI <1.5) and metastases (PI >1.5), with a 77% accuracy in both diseases. Doppler US is a valuable addition in the US evaluation of cervical lymphadenopathy. 3
47. Zhang J, Wang Y, Yu B, Shi X, Zhang Y. Application of Computer-Aided Diagnosis to the Sonographic Evaluation of Cervical Lymph Nodes. Ultrason Imaging. 2016;38(2):159-171. Observational-Dx 278 patients; 278 nodes To evaluate a computerized system developed in our previous study for automatic extraction of 10 features and estimation of the malignancy probability of cervical nodes in sonograms. With the computer aid, the performances of radiologists improved significantly, as indicated by the increase in the area under the ROC curve (Az) from 0.843 to 0.896 (p = 0.031) and from 0.705 to 0.822 (p < 0.001), for the expert and resident groups, respectively. Agreement among all 10 radiologists improved from slight to moderate as indicated by an increase in the kappa value from 0.195 to 0.421 (p < 0.001). The average performance of residents with aid (Az = 0.822) was close to that of experts without aid (Az = 0.843). 2
48. Tillman BN, Glazer TA, Ray A, Brenner JC, Spector ME. A lean neck mass clinic model: Adding value to care. Laryngoscope. 2015;125(11):2509-2513. Observational-Dx 61 patients (28 female; 33 male) To demonstrate that ultrasound-guided fine needle aspiration (USFNA) with on-site cytopathologic analysis eliminates unnecessary diagnostic testing, return visits, and repeat procedures and optimizes quality of care. Diagnosis was made in 93.4% (n=57) of patients, allowing for counseling and treatment planning at the first visit. To obtain a diagnosis, more than half (57.4%, n=35) of our patients required additional passes, which implies that they would have required an additional visit without on-site cytopathologic analysis. Treatment included observation in 42.6% (n=26) of patients, surgery in 32.8 % (n=20) of patients, and nonsurgical treatment (chemotherapy, radiation, other) in 24.6% (n=15) of patients. The average time from check-in to checkout including the clinic visit, biopsy, and treatment counseling was 103 minutes, and the average round trip mileage traveled per patient was 127.6 miles. 3
49. Fakhry C, Agrawal N, Califano J, et al. The use of ultrasound in the search for the primary site of unknown primary head and neck squamous cell cancers. Oral Oncol. 2014;50(7):640-645. Observational-Dx 10 subjects To investigate the potential of ultrasound to detect primary tumors within the oropharynx among patients who present with Head and neck squamous cell cancers (HNSCCs) of unknown primary site (UP). 10 cases and 20 controls were enrolled. Positron emission tomography (PET)/computed tomography (CT) scans were negative/nonspecific (9), or suspicious (1) for a primary lesion. On ultrasonography (US), predominantly hypoechoic (9 of 10) lesions were visualized consistent with base of tongue (n=7) or tonsil (n=3) primary tumors. On operative examination, 5 of 10 were appreciated. Two additional primaries were confirmed with biopsies "directed" by preoperative US. This represents an overall diagnostic rate of 70%, which is 20% higher than our detection rate for 2008-2010. The three cases in which a suspicious lesion was visualized on US, yet remained UP despite further interventions, could represent false positives, misclassification or operator variability. No lesions were suspected among the controls. 3
50. Bhatia KS, Cho CC, Yuen YH, Rasalkar DD, King AD, Ahuja AT. Real-time qualitative ultrasound elastography of cervical lymph nodes in routine clinical practice: interobserver agreement and correlation with malignancy. Ultrasound Med Biol. 2010;36(12):1990-1997. Observational-Dx 74 nodes (37 malignant, 37 benign) in 74 patients To evaluate real-time qualitative US elastography for sonographically abnormal cervical lymphnodes undergoing fine needle aspiration for cytology in a routine clinical setting. The main aim was to assess its utility for predicting malignancy within the spectrum of pathologies encountered in routine practice. In addition, as qualitative elastography is based on subjective evaluation of elastograms, a second objective was to assess the interobserver agreement for this technique. Dynamic cine loops of elasticity imaging were scored by three independent observers for the proportion of stiff areas from ES1-4 (soft to stiff). There was fair to good interobserver agreement as indicated by weighted kappa statistic from 0.374 to 0.738. Median ES for benign and malignant nodes were 2 and 3 respectively. ES was higher in malignant nodes (P=0.0003-0.0049, Mann Whitney U tests) although areas under receiver operating characteristic curves (0.68-0.74) indicated suboptimal discrimination. The optimal discriminatory cut-off, ES >2, achieved only 62.2% sensitivity, 83.8% specificity and 73% accuracy for malignancy. Improvements in reliability and accuracy of real-time qualitative US elastography are required for it to be adopted into routine clinical practice. 3
51. Che D, Zhou X, Sun ML, Wang X, Jiang Z, Changjun W. Differentiation of metastatic cervical lymph nodes with ultrasound elastography by virtual touch tissue imaging: preliminary study. J Ultrasound Med. 2015;34(1):37-42. Observational-Dx 81 patients To investigate the clinical usefulness of acoustic radiation force impulse elastography for the differential diagnosis of cervical lymph nodes. Most benign lymph nodes were slightly darker or the same in brightness compared with surrounding tissue, whereas most metastatic nodes were obviously darker. The mean area ratio of benign lymph nodes +/- SD (1.05 +/- 0.15) was statistically lower than the mean area ratio of metastatic lymph nodes (1.39 +/- 0.20; P < 0.001). The area ration cutoff level for metastatic lymph nodes was estimated to be 1.16. With the use of a receiver operating characteristic curve with this cutoff value, the area ratio predicted malignancy with sensitivity of 91.1%, specificity of 83.3%, and an area under the curve of 0.925. 3
52. Choi YJ, Lee JH, Lim HK, et al. Quantitative shear wave elastography in the evaluation of metastatic cervical lymph nodes. Ultrasound Med Biol. 2013;39(6):935-940. Observational-Dx 15 patients including 67 lymph nodes. To compare the diagnostic performance of shear wave elastography (SWE) with that of gray-scale ultrasound (US) in differentiating metastatic from benign lymph nodes in patients with head and neck malignancies. The maxSM value was significantly higher for metastatic than benign lymph nodes (41.06 +/- 36.34 kPa vs. 14.22 +/- 4.19 kPa, p < 0.0001) at a cutoff level of 19.44 kPa. Accuracy, sensitivity and specificity were 94, 91 and 97%, respectively, for SWE, and 91, 88 and 94%, respectively, for gray-scale US. Multiple regression analysis showed that the maxSM value (r = 0.882) and gray-scale US criteria (r = 0.837) were independent variables. 3
53. Desmots F, Fakhry N, Mancini J, et al. Shear Wave Elastography in Head and Neck Lymph Node Assessment: Image Quality and Diagnostic Impact Compared with B-Mode and Doppler Ultrasonography. Ultrasound Med Biol. 2016;42(2):387-398. Observational-Dx 56 patients To assess the diagnostic performance of shear wave elastography (SWE) in comparison to B-mode and Doppler ultrasonography in differentiating benign from malignant head and neck lymph nodes (HNLNs). Thirty HNLNs were malignant (48%). mumax intra-observer reproducibility was 0.899 (0.728 in sub-centimeter subgroup). Malignant HNLNs were stiffer (mumax = 72.4 +/- 59.0 kPa) compared with benign nodes (mumax = 23.3 +/- 25.3 kPa) (p < 0.001). Among the quantitative criteria, mumax had the highest diagnostic accuracy (area under the curve = 0.903 +/- 0.042), especially in the sub-centimeter subgroup (area under the curve = 0.929 +/- 0.045; p < 0.001) in which the area under the curve was significantly higher compared with the other quantitative criteria (p < 0.05). The additional use of SWE combined with B-mode tended to improve diagnostic accuracy (p > 0.05). 3
54. Fujiwara T, Tomokuni J, Iwanaga K, Ooba S, Haji T. Acoustic radiation force impulse imaging for reactive and malignant/metastatic cervical lymph nodes. Ultrasound Med Biol. 2013;39(7):1178-1183. Observational-Dx Forty-two cervical lymph nodes from 19 patients. To compare lymph node stiffness using acoustic radiation force impulse (ARFI) imaging in patients with cervical lymph node swelling. SWV of reactive lymph nodes was 1.52 +/- 0.48 m/s, and that of metastatic/malignant lymph nodes was 2.46 +/- 0.75 m/s. A SWV > 1.9 m/s was very useful metastatic lymph node classification, with 95.0% specificity, 81.8% sensitivity and 88.0% overall accuracy. The area under the receiver operating characteristic curve was 0.923 (95% confidence interval, 0.842-1.000). 3
55. Jin ZQ, Lin MY, Hu WH, Li WY, Bai SJ. Gray-scale ultrasonography combined with elastography imaging for the evaluation of papillary thyroid microcarcinoma: as a prognostic clinicopathology factor. Ultrasound Med Biol. 2014;40(8):1769-1777. Observational-Dx 119 patients To evaluate the importance of gray-scale ultrasound combined with elastography to predict extrathyroidal extension and cervical lymph node (LN) metastasis in patients with PTMC. The results indicated that pathological extrathyroidal extension was significantly associated with T staging on US, extrathyroidal extension on US, bilaterality on US, boundary, strain ratio and hard malignancy as measured with the Rago score. Central LN metastasis on pathology was significantly associated with central LN metastasis on US, lateral LN metastasis on US, multifocality on US and bilaterality on US. Lateral LN metastasis on US was significantly associated with lateral LN metastasis on pathology. On multivariate analysis, T staging on US, extrathyroidal extension on US and hard malignancy as measured with the Rago score were significantly associated with pathological extrathyroidal extension. Lateral LN metastasis on US and bilaterality on US were independent factors in predicting central LN metastasis on pathology. Lateral LN metastasis on US was the predictive factor for lateral LN metastasis on pathology. 3
56. Lenghel LM, Bolboaca SD, Botar-Jid C, Baciut G, Dudea SM. The value of a new score for sonoelastographic differentiation between benign and malignant cervical lymph nodes. Med Ultrason. 2012;14(4):271-277. Observational-Dx 42 patients including 30 benign and 39 malignant lymph nodes assessed. To explore the diagnostic value of sonoelastography for the differentiation between benign and malignant superficial lymph nodes of the neck. The analysis of the interobserver agreement for the investigated score provided a weighted Kappa = 0.687, 95%CI [0.572 to 0.802] and standard error = 0.059. In the differentiation benign - malignant, the AUROC was 0.846, with sensitivity of 66.67% and specificity of 96.67% for score &gt; 3. In the differentiation between benign and metastasis, the same criterion provided an AUROC of 0.855, with sensitivity of 71.43 and specificity of 96.67%. 3
57. Meng W, Xing P, Chen Q, Wu C. Initial experience of acoustic radiation force impulse ultrasound imaging of cervical lymph nodes. Eur J Radiol. 2013;82(10):1788-1792. Observational-Dx 123 patients To evaluate acoustic radiation force impulse imaging for cervical lymphadenopathy in routine clinical practice and to correlate the acoustic radiation force impulse values with the morphological signs and the pathological results, which were used as the reference standard. The diagnostic performance of acoustic radiation force impulse values were evaluated with respect to sensitivity, specificity, and area under the curve using a receiver operating characteristic curve analysis. The mean virtual touch tissue quantification values of the benign lesions (2.01 +/- 0.95 m/s) differed from that of the malignant lesions (4.61 +/- 2.56 m/s; P<0.001). The cutoff level for virtual touch tissue quantification value for malignancy was estimated to be 2.595 m/s. Using the receiver operating characteristic curve curves with the cutoff value, the virtual touch tissue quantification value predicted malignancy with a sensitivity of 82.9%, specificity of 93.1% and gave an areas under the curve of 0.906 (95% CI 0.857-0.954). 3
58. Poanta L, Serban O, Pascu I, Pop S, Cosgarea M, Fodor D. The place of CEUS in distinguishing benign from malignant cervical lymph nodes: a prospective study. Med Ultrason. 2014;16(1):7-14. Observational-Dx 61 patients To evaluate the ability of contrast-enhanced ultrasonography (CEUS) compared to gray-scale B-mode and color Doppler ultrasound in differentiate benign versus malign superficial cervical lymph nodes. Of all the nodes, 32 were benign and 29 were malignant (metastases). Solbiati index was higher in benign nodes (2.23 +/- 0.84 vs 1.50 +/- 0.48, p<0.05). Doppler parameters (vessel location, vascular pattern, pedicullum number, resistivity index, and pulsatility index) were significantly lower in benign nodes (p<0.001), and ROC analysis returned excellent results. For CEUS, derived peak intensity (DPI %) was higher in benign nodes (17.72 +/- 5.43 vs 11.76 +/- 4.88, p<0.05); regional blood volume (RBV) was also higher (849.8 +/- 467.1 vs 458.3 +/- 283.3, p<0.05). The time to peak (TTP, s) and area under the curve (AUC, cm2) were similar in both benign and malignant nodes. Enhancement pattern was the most accurate to characterize benign versus malignant nodes. Sensitivity and specificity were higher for DPI, RBV and enhancement pattern from CEUS, according to ROC analysis, compared to gray scale ultrasound, but lower than color Doppler. Analyzing the place of CEUS in lymph node evaluation we found that CEUS is most useful for the evaluation of the lymph nodes with uncertain aspect at gray scale and Doppler evaluation. 3
59. Griauzde J, Srinivasan A. Imaging of vascular lesions of the head and neck. Radiol Clin North Am. 2015;53(1):197-213. Observational-Dx N/A To address clinical presentation, differential diagnosis, differentiating features, characteristic imaging findings, as well as a brief discussion of treatment options of these lesions. No results stated in abstract. 4
60. Neves F, Huwart L, Jourdan G, et al. Head and neck paragangliomas: value of contrast-enhanced 3D MR angiography. AJNR Am J Neuroradiol. 2008;29(5):883-889. Observational-Dx 27 patients To determine whether the combination of elliptic centric contrast-enhanced Magnetic Resonance angiography (CE-MRA) and unenhanced and enhanced spin-echo imaging (conventional MR imaging) is more accurate than conventional MR imaging alone to assess paragangliomas in the head and neck. Forty-six lesions were found in 27 patients. In the assessment of paragangliomas, the combination of conventional MR imaging and CE-MRA was significantly superior to conventional MR imaging alone. Sensitivity and specificity respectively were the following: for CE-MRA, 100% and 94%; and for conventional MR imaging, 94% and 41%. The specificity of CE-MRA was significantly higher than that of conventional MR imaging (P = .004). There was good-to-excellent interobserver agreement for the paraganglioma probability with CE-MRA (nonweighted kappa, 0.67-0.77), whereas there was fair-to-good interobserver agreement with conventional MR imaging (nonweighted kappa, 0.50-0.65). 2
61. Romano A, Tavanti F, Rossi Espagnet MC, et al. The role of time-resolved imaging of contrast kinetics (TRICKS) magnetic resonance angiography (MRA) in the evaluation of head-neck vascular anomalies: a preliminary experience. Dentomaxillofac Radiol. 2015;44(3):20140302. Observational-Dx 6 patients To verify Time-resolved imaging of contrast kinetics-Magnetic Resonance angiography (TRICKS-MRA) impact on diagnosis and perioperative management in the primary assessment of Head–neck vascular anomalies (HNVAs). Time-resolved imaging of contrast kinetics-MR angiography (TRICKS-MRA) could be achieved in all cases. Three subjects were treated based on TRICKS-MRA imaging findings and subsequent DSA examination. In all of them, DSA confirmed the vascular architecture of HNVAs shown by TRICKS-MRA. In the other three patients, a close follow up to assess the evolution of the suspected haemangioma was preferred. 2
62. Razek AA, Gaballa G, Megahed AS, Elmogy E. Time resolved imaging of contrast kinetics (TRICKS) MR angiography of arteriovenous malformations of head and neck. Eur J Radiol. 2013;82(11):1885-1891. Observational-Dx 19 patients To evaluate vasculature of arteriovenous malformations (AVMs) of head and neck with time resolved imaging of contrast kinetics (TRICKS) MR angiography (MRA). The average TRICKS-MRA image quality score as judged by reader 1 was 3.89 +/- 1.15 and that as judged by reader 2 was 3.89 +/- 0.10, which yielded excellent interobserver agreement (k=0.77, 95% CI=0.53-0.98, r=0.78, P=0.001). The interobserver agreement of both readers was excellent for the arterial feeders (k=0.81, 95% CI=0.57-1.00, r=0.83, P=0.001), excellent for the nidus (k=0.91, 95% CI=0.75-1.00, r=0.92, P=0.001), and good for the venous drainage (k=0.77, 95% CI=0.53-0.98, r=0.78, P=0.001). The arterial feeders were single (n=14) or multiple (n=5), the nidus was large (n=16) or small (n=3) and the venous drainage was into the internal jugular (n=17) or the external jugular (n=2) veins. Three patients with small nidus and single arterial feeder were treated with sclerotherapy. Eleven patients with large nidus and single arterial feeder were referred for embolization. Combined embolization and surgery were done for five patients with large nidus and multiple arterial feeders. 3
63. Archier A, Varoquaux A, Garrigue P, et al. Prospective comparison of (68)Ga-DOTATATE and (18)F-FDOPA PET/CT in patients with various pheochromocytomas and paragangliomas with emphasis on sporadic cases. Eur J Nucl Med Mol Imaging. 43(7):1248-57, 2016 Jul. Observational-Dx 30 patients To compare (68)Ga-labeled somatostatin analogs ((68)Ga-DOTA-SSA) positron emission tomography (PET)/computed tomography (CT), (18)F-FDOPA PET/CT, and conventional imaging in patients with various Pheochromocytomas/paragangliomas (PHEOs/ PGLs) with a special emphasis on sporadic cases, including those located in the adrenal gland. The patient-based sensitivities were 93 % (28/30), 97 % (29/30), and 93 % (28/30) for (68)Ga-DOTATATE PET/CT, (18)F-FDOPA PET/CT, and conventional imaging, respectively. The lesion-based sensitivities were 93 % (43/46), 89 % (41/46), and 76 % (35/46) for (68)Ga-DOTATATE PET/CT, (18)F-FDOPA PET/CT, and conventional imaging respectively (p = 0.042). (68)Ga-DOTATATE PET/CT detected a higher number of HNPGLs (30/30) than (18)F-FDOPA PET/CT (26/30; p = 0.112) and conventional imaging (24/30; p = 0.024). (68)Ga-DOTATATE PET/CT missed two PHEOs of a few millimeters in size and a large recurrent PHEO. One lesion was considered false-positive on (68)Ga-DOTATATE PET/CT and corresponded to a typical focal lesion of fibrous dysplasia on magnetic resonance imaging (MRI). Among the 11 lesions missed by conventional imaging, 7 were detected by conventional imaging with knowledge of the PET results (4 HNPGLs, 2 LNs, and 1 recurrent PHEO). 2
64. Heimburger C, Veillon F, Taieb D, et al. Head-to-head comparison between 18F-FDOPA PET/CT and MR/CT angiography in clinically recurrent head and neck paragangliomas. Eur J Nucl Med Mol Imaging. 2017;44(6):979-987. Observational-Dx 16 patients To assess the diagnostic value of [18F]-L-fluoro-L-3, 4-dihydroxyphenylalanine (18F-FDOPA) and magnetic resonance/ computed tomography (MR/CT)  magnetic resonance angiography (MRA/CTA) in Head and neck paragangliomas (HNPGLs) patients with clinical relapse during their follow-up. [18F]-L-fluoro-L-3, 4-dihydroxyphenylalanine (18F-FDOPA) positron emission tomography/ computed tomography (PET/CT) and magnetic resonance angiography (MRA/CTA) were concordant in 14 patients and in disagreement in 2 patients. 18F-FDOPA PET/CT and MRA/CTA identified, respectively, 12 and 10 presumed recurrent HNPGLs in 12 patients. The two lesions diagnosed by PET/CT only were confirmed during follow-up by otoscopic examination and MRA performed 29 and 17 months later. 18F-FDOPA PET/CT images were only slightly influenced by the posttreatment sequelae, showing a better interobserver reproducibility than MRA/CTA. Finally, in 2 of the 16 studied patients, 18F-FDOPA PET/CT detected two additional synchronous primary HNPGLs. 2
65. Janssen I, Chen CC, Taieb D, et al. 68Ga-DOTATATE PET/CT in the Localization of Head and Neck Paragangliomas Compared with Other Functional Imaging Modalities and CT/MRI. J Nucl Med. 57(2):186-91, 2016 Feb. Observational-Dx 20 patients To assess the clinical utility of this functional imaging modality in parasympathetic head and neck paragangliomas (HNPGLs) compared with anatomic imaging with computed tomography/ Magnetic resonance imaging (CT/MRI) and other functional imaging modalities, including (18)F-fluorohydroyphenylalanine ((18)F-FDOPA) PET/CT, currently the gold standard in the functional imaging of HNPGLs. Thirty-eight lesions in 20 patients were detected, with (18)F-FDOPA PET/CT identifying 37 of 38 and CT/MRI identifying 23 of 38 lesions (P < 0.01). All 38 and an additional 7 lesions (P = 0.016) were detected on (68)Ga-DOTATATE PET/CT. Significantly fewer lesions were identified by (18)F-FDG PET/CT (24/38, P < 0.01) and (18)F-FDA PET/CT (10/34, P < 0.01). 2
66. Inohara H, Akahani S, Yamamoto Y, et al. The role of fine-needle aspiration cytology and magnetic resonance imaging in the management of parotid mass lesions. Acta Otolaryngol. 2008;128(10):1152-1158. Observational-Dx 81 patients To address the relative value of Fine-needle aspiration cytology (FNAC) and magnetic resonance imaging (MRI) in relation to the differential diagnosis of benign and malignant parotid mass lesions. Unsharp margin and infiltration into adjacent tissues on MRI significantly correlated with a malignant histology. The sensitivity/specificity/accuracy of FNAC and MRI were 90%/95%/94% and 81%/92%/89%, respectively. Either FNAC or MRI served equally to predict the malignant nature of parotid mass lesions. Furthermore, the combination of FNAC and MRI yielded no diagnostic advantage over either modality alone. Accurate histological typing rates by FNAC were 80% and 62% for benign and malignant lesions, respectively. 2
67. de Ru JA, van Leeuwen MS, van Benthem PP, Velthuis BK, Sie-Go DM, Hordijk GJ. Do magnetic resonance imaging and ultrasound add anything to the preoperative workup of parotid gland tumors? J Oral Maxillofac Surg. 2007;65(5):945-952. Observational-Dx 99 patients To assess the additional value of magnetic resonance imaging (MRI) and ultrasound (US) to physical examination (PE) and fine needle aspiration cytology (FNAC) in the preoperative determination of the location and histology of parotid gland tumors. Of the MRI characteristics, incomplete demarcation from normal parotid gland tissue showed the highest positive predictive value (PPV) for malignancy of 0.48. Of the US characteristics, enlarged lymph nodes yielded the highest PPV for malignancy of 0.5. Cytology correctly predicted the benign or malignant nature of the tumor in all cases. Superficial location was well predicted on PE with a PPV of 0.8, slightly better on MRI (PPV of 0.87), and worse on US (PPV of 0.7). 2
68. Eom HJ, Lee JH, Ko MS, et al. Comparison of fine-needle aspiration and core needle biopsy under ultrasonographic guidance for detecting malignancy and for the tissue-specific diagnosis of salivary gland tumors. AJNR Am J Neuroradiol. 2015;36(6):1188-1193. Observational-Dx 412 patients To compare the diagnostic accuracy of ultrasonography-guided fine-needle aspiration versus ultrasonography-guided core needle biopsy for detecting malignant tumors of the salivary gland and for the tissue-specific diagnosis of salivary gland tumors in a single tertiary hospital. The inconclusive rates of ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy were 19% and 4%, respectively (P < .001). The overall accuracy of ultrasonography-guided core needle biopsy for diagnosing malignant tumors was significantly higher than that of ultrasonography-guided fine-needle aspiration (P = .024). The correct tissue-specific diagnosis rates of ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy were 95% versus 97% for benign tumors (P = .648) and 67% versus 80% for malignant tumors (P = .310). Trainees showed significantly lower accuracy with ultrasonography-guided fine-needle aspiration than with ultrasonography-guided core needle biopsy for diagnosing malignant tumors (P = .021). There was no difference between the diagnostic accuracy of ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy according to the internal composition of the lesions. There were no complications requiring intervention or hospitalization in our patients. 3
69. Huang YC, Wu CT, Lin G, Chuang WY, Yeow KM, Wan YL. Comparison of ultrasonographically guided fine-needle aspiration and core needle biopsy in the diagnosis of parotid masses. J Clin Ultrasound. 2012;40(4):189-194. Observational-Dx 171 patients To retrospectively compare the accuracies of ultrasound-guided fine-needle aspiration (USFNA) and ultrasound-guided core needle biopsy (USCNB) in the diagnosis of parotid masses. USCNB had a significantly higher sensitivity (94.1%) than USFNA (55.6%) (p < 0.05) in differentiating benign lesions from malignant conditions. The specificity and overall accuracy of USCNB were higher than those of USFNA (100% and 98.4% versus 93.3% and 86.9%, respectively). USCNB provided more specific diagnosis than USFNA (100% versus 93.3%, p < 0.05). All six patients with lymphomas who underwent USCNB were accurately diagnosed, whereas all four patients with lymphomas who underwent USFNA were not. 3
70. Ishibashi M, Fujii S, Kawamoto K, et al. Capsule of parotid gland tumor: evaluation by 3.0 T magnetic resonance imaging using surface coils. Acta Radiol. 2010;51(10):1103-1110. Observational-Dx 78 patients To evaluate the diagnostic usefulness of 3.0 T (telsa) magnetic resonance (MR) imaging with surface coils for detection of the parotid gland tumor capsule, and to clarify the characteristics of the capsules. Capsules completely surrounding the tumor on MR imaging yielded a sensitivity of 87.7% (50/57), specificity of 90.5% (19/21), and accuracy of 88.5% (69/78). Benign tumors had a capsule completely surrounding the tumor significantly more often than malignant tumors (P = 0.009). Concerning capsular irregularity, malignant tumors tended to have more irregular capsules than benign tumors, although there were no significant differences. The capsules of malignant tumors enhanced significantly more strongly than those of benign tumors (P = 0.018). 3
71. Wierzbicka M, Kaluzny J, Szczepanek-Parulska E, et al. Is sonoelastography a helpful method for evaluation of parotid tumors? Eur Arch Otorhinolaryngol. 2013;270(7):2101-2107. Observational-Dx 43 patients To examine whether the combination of conventional ultrasonography (US) with sonoelastography might improve the reliability of parotid tumor evaluation. The mean stiffness value was 146.6 kPa in 10 malignant tumors (mostly ES4) and 88.7 kPa in 33 benign tumors (mostly ES2 and ES3). The differences in tissue stiffness between normal parotid parenchyma in the reference group and the mean value for all tumors in the examined group were statistically significant (p < 0.001), and so was the case with the differences between the benign and malignant tumors (p < 0.001). Low stiffness scores (ES1,2) were found in 2 malignant and 15 benign tumors while high scores (ES3,4) were found in 8 malignancies and 18 benign tumors. Sonoelastography overlapping elasticity to the grayscale images supports additional informations. 3
72. Zaghi S, Hendizadeh L, Hung T, Farahvar S, Abemayor E, Sepahdari AR. MRI criteria for the diagnosis of pleomorphic adenoma: a validation study. Am J Otolaryngol. 2014;35(6):713-718. Observational-Dx 103 cases To validate an magnetic resonance imaging (MRI) algorithm characteristic of pleomorphic adenoma (PA). A total of 103 parotidectomy cases with adequate MRI studies were identified (pleomorphic adenoma n=41, mucoepidermoid carcinoma n=11, Warthin's tumor n=8, adenoid cystic carcinoma n=6, oncocytoma n=6, acinic cell carcinoma n=5, salivary duct carcinoma n=5, and other n=21). Eighteen of 21 cases that met all five "high probability" MRI criteria were consistent with PA on final histopathology; 3 were consistent with carcinoma. MRI had a specificity of 95.1% [95% confidence interval: 85.6-98.7%] and sensitivity of 43.9% [95% C.I.: 28.8-60.1%] for PA. The positive predictive value was 85.7% [95% C.I.: 70.4-100%] and the negative predictive value was 71.9% [95% C. I.: 62.0-81.9%]. The overall diagnostic accuracy was 74.8% [95% C.I.: 66.2-83.3%]. 3
73. Brucker JL, Gentry LR. Imaging of head and neck emergencies. Radiol Clin North Am. 2015;53(1):215-252. Review/Other-Dx N/A To review the Imaging of head and neck emergencies. No results stated in abstract. 4
74. Lim CY, Chang HS, Nam KH, Chung WY, Park CS. Preoperative prediction of the location of parotid gland tumors using anatomical landmarks. World J Surg. 2008;32(10):2200-2203. Observational-Dx 100 patients To assess the accuracy of landmarks relative to tumor size. Of the four landmarks, the U line was the most accurate (94%), sensitive (89.3%), and specific (97.7%) in predicting tumor location. However, for tumors < or =2 cm in diameter, FN line (p = 0.022) and RV (p = 0.028) were significantly more accurate than U line and CA. 3
75. Bisdas S, Baghi M, Wagenblast J, et al. Differentiation of benign and malignant parotid tumors using deconvolution-based perfusion CT imaging: feasibility of the method and initial results. Eur J Radiol. 2007;64(2):258-265. Observational-Dx 27 patients To evaluate the feasibility of perfusion computed tomography (CT) (CTP) of the parotid gland and attempted to differentiate benign from malignant tumors. Perfusion maps of all tumors were successfully obtained. High Pearson correlation coefficients comparing the two readers' visually measured abnormalities were observed (r=0.79-0.86, P=0.001) for all perfusion maps, The mean transit time (MTT) and surface product (PS) values between malignant and benign tumors were not significantly different. The blood flow (BF) and blood volume (BV) values were statistically significant different between the benign and malignant tumors (0.00<P<0.02). Only the BV ratio criterion between malignant and benign neoplasms was statistically significant (P<0.004). 2
76. Yerli H, Aydin E, Coskun M, et al. Dynamic multislice computed tomography findings for parotid gland tumors. J Comput Assist Tomogr. 2007;31(2):309-316. Observational-Dx 21 patients To research the enhancement features of parotid gland masses in detail and characterize if the masses were Warthin tumors, adenomas, or malignant tumors. There were 11 Warthin tumors, 8 pleomorphic adenomas, 5 malignant tumors, and 1 basal cell adenoma. Ten Warthin tumors showed rapid contrast enhancement at 30 seconds and rapid reduction of enhancement from the first to the fourth phase. The basal cell adenoma showed also a peak enhancement at 30 seconds. Seven pleomorphic adenomas showed increased enhancement through the first 3 phases. Four malignant tumors showed peak enhancement at 90 seconds. Statistically significant differences within and among tumor groups were determined. 3
77. Imaizumi A, Kuribayashi A, Okochi K, et al. Differentiation between superficial and deep lobe parotid tumors by magnetic resonance imaging: usefulness of the parotid duct criterion. Acta Radiol. 2009;50(7):806-811. Observational-Dx 40 patients To evaluate the usefulness of using the parotid duct, in addition to the retromandibular vein, for differentiating between superficial and deep lobe parotid tumors on magnetic resonance (MR) images. Using the retromandibular vein criterion, 71% of deep lobe and 86% of superficial lobe tumors were correctly diagnosed, providing an accuracy of 81%. However, the accuracy achieved when using the parotid duct criterion was 100%, although it could be applied to only 28 of the 42 cases. Based on these results, we defined the following diagnostic method: the parotid duct criterion is first applied, and for cases in which it cannot be applied, the retromandibular vein criterion is used. The accuracy of this method was 88%, which was better than that achieved using the retromandibular vein criterion alone. 2
78. Kontzialis M, Glastonbury CM, Aygun N. Evaluation: Imaging Studies. Adv Otorhinolaryngol. 2016;78:25-38. Review/Other-Dx N/A To review the advanced imaging techniques that help to characterize salivary gland (SG) tumors. No results stated in abstract. 4
79. Christe A, Waldherr C, Hallett R, Zbaeren P, Thoeny H. MR imaging of parotid tumors: typical lesion characteristics in MR imaging improve discrimination between benign and malignant disease. AJNR Am J Neuroradiol. 2011;32(7):1202-1207. Observational-Dx 84 patients To review our experience using conventional Magnetic Resonance (MR) imaging of the neck in the evaluation of parotid tumors and to evaluate which MR imaging findings are best able to predict malignant histology. The 57 (68%) benign and 27 (32%) malignant tumors consisted of 29 pleomorphic adenomas, 17 Warthin tumors, 11 various benign tumors, 5 mucoepidermoid carcinomas, 3 adenoid cystic carcinomas, 1 acinic cell carcinoma, 1 carcinoma ex pleomorphic adenoma, 9 metastases, and 8 various malignant neoplasms. Specific signs predictive of malignancy were the following: T2 hypointensity of the parotid tumor (P = .048), ill-defined margins (P = .001), diffuse growth (P = .012), infiltration of subcutaneous tissue (P = .0034), and lymphadenopathy (P = .012). 2
80. Kato H, Kanematsu M, Watanabe H, Mizuta K, Aoki M. Salivary gland tumors of the parotid gland: CT and MR imaging findings with emphasis on intratumoral cystic components. Neuroradiology. 2014;56(9):789-795. Observational-Dx 72 patients To assess computed tomography (CT) and magnetic resonance (MR) imaging findings of salivary gland tumors of the parotid gland with emphasis on intratumoral cystic components. The prevalence of cystic components was greater in malignant than benign tumors (79 vs. 50%, p < 0.05). The number and occupying rate were similar between benign and malignant tumors. The irregular margins were more frequent in malignant than benign tumors (73 vs. 27%, p < 0.01). The frequency of eccentric location was greater in benign than malignant tumors (91 vs. 55%, p < 0.01), whereas the frequency of centric location was greater in malignant than benign tumors (32 vs. 0%, p < 0.01). On T1-weighted images, the frequency of hyperintensity was greater in benign than malignant tumors (50 vs. 9%, p < 0.01), whereas that of isointensity was greater in malignant than benign tumors (50 vs. 0%, p < 0.01). Multiple logistic regression analysis showed that the absence of irregular margins of cystic components only was significantly correlated with the presence of benign salivary gland tumors (p < 0.01). 3
81. Kato H, Fujimoto K, Matsuo M, Mizuta K, Aoki M. Usefulness of diffusion-weighted MR imaging for differentiating between Warthin's tumor and oncocytoma of the parotid gland. Jpn J Radiol. 2017;35(2):78-85. Observational-Dx 41 patients To assess the efficacy of diffusion-weighted (DW) Magnetic Resonance (MR) imaging for differentiating between Warthin's tumor and oncocytoma of the parotid gland. The signal intensity ratios (SIRs) on both T2-weighted images (0.92 +/- 0.18 vs 0.65 +/- 0.13, p < 0.01) and DW images (1.24 +/- 0.42 vs 0.43 +/- 0.16, p < 0.001) were higher in Warthin's tumors than in oncocytomas. ADCs (0.79 +/- 0.11 vs 1.06 +/- 0.06 x 10-3 mm2/s, p < 0.001) were lower in Warthin's tumors than in oncocytomas. No significant differences in the SIRs on T1-weighted images (1.09 +/- 0.12 vs. 0.99 +/- 0.07, p = 0.051) and maximum standardized uptake values (SUVmax) (8.22 +/- 3.86 vs. 8.11 +/- 1.33, p = 0.864) were found between Warthin's tumor and oncocytoma. 3
82. Expert Panel on Neurologic Imaging:, Policeni B, Corey AS, et al. ACR Appropriateness Criteria Cranial Neuropathy. J. Am. Coll. Radiol.. 14(11S):S406-S420, 2017 Nov. Review/Other-Dx N/A Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for cranial neuropathy. No results stated in abstract. 4
83. Alibek S, Zenk J, Bozzato A, et al. The value of dynamic MRI studies in parotid tumors. Acad Radiol. 2007;14(6):701-710. Observational-Dx 112 patients To evaluate the ability of dynamic contrast-enhanced magnetic resonance imaging (MRI) to differentiate several tumor entities of the parotid gland in a prospective clinical trial. Four characteristic intensity-time curves were observed: pleomorphic adenoma showed a gradual increase in signal intensity, followed by a plateau phase on a low intensity level. Cysts showed a vacillating course at a low signal intensity level. Adenolymphomas as well as carcinomas showed a rapid increase in signal intensity followed by a plateau phase. Statistic significance was found for the time-to-peak values for adenolymphomas and pleomorphic adenomas and for the maximum peak signal intensity values for carcinomas. Together with other morphologic MRI criteria (contrast enhancement, border characteristics) and clinical features, a differentiation between adenolymphoma and carcinoma was possible. 2
84. Eida S, Ohki M, Sumi M, Yamada T, Nakamura T. MR factor analysis: improved technology for the assessment of 2D dynamic structures of benign and malignant salivary gland tumors. J Magn Reson Imaging. 2008;27(6):1256-1262. Observational-Dx 36 patients To establish an MR factor analysis technique for two-dimensional (2D) Magnetic Resonance (MR) dynamic structures of benign and malignant salivary gland tumors. The MR factor analysis technique allowed the pixel-to-pixel evaluation of the contrast enhancement kinetics of the salivary gland tumors. The 2D distributions of the time-intensity curve (TIC) patterns correlated well with the histological features of the salivary gland tumors and allowed more detailed dynamic structures of the tumors compared with the results obtained by the conventional dynamic study analysis. 3
85. Eida S, Sumi M, Sakihama N, Takahashi H, Nakamura T. Apparent diffusion coefficient mapping of salivary gland tumors: prediction of the benignancy and malignancy. AJNR Am J Neuroradiol. 2007;28(1):116-121. Observational-Dx 31 patients To evaluate the preoperative apparent diffusion coefficient (ADC) maps of benign and malignant salivary gland tumors. The ADC maps effectively depicted the histologic features of the salivary gland tumors, such as presence of cancer cells, myxomatous tissues, fibrosis, necrosis, cyst formation, and lymphoid tissues. The ADC maps showed that more frequent areas with high ADCs (> or = 1.8 x 10(-3) mm(2)/s) were significantly greater in benign tumors than in malignant tumors. The sensitivity and specificity for high ADC occupying fewer than 5% of the area of a tumor was 89% and 100%, respectively, resulting in 97% accuracy, 100% positive predictive value, and 96% negative predictive value. 3
86. Fruehwald-Pallamar J, Czerny C, Holzer-Fruehwald L, et al. Texture-based and diffusion-weighted discrimination of parotid gland lesions on MR images at 3.0 Tesla. NMR Biomed. 2013;26(11):1372-1379. Observational-Dx 38 patients To evaluate whether texture-based analysis of standard magnetic resonance imaging (MRI) sequences and diffusion-weighted imaging can help in the discrimination of parotid gland masses. Significant differences were found in the mean apparent diffusion coefficient (ADC) values between Warthin tumors and pleomorphic adenomas, as well as between Warthin tumors and benign lesions. Contrast-enhanced T1-weighted images contained the most relevant textural information for the discrimination between benign and malignant parotid masses, and also for the discrimination between pleomorphic adenomas and Warthin tumors. STIR images contained the least relevant texture features, particularly for the discrimination between pleomorphic adenomas and Warthin tumors. 3
87. Habermann CR, Arndt C, Graessner J, et al. Diffusion-weighted echo-planar MR imaging of primary parotid gland tumors: is a prediction of different histologic subtypes possible? AJNR Am J Neuroradiol. 2009;30(3):591-596. Observational-Dx 136 patients To determine the value of echo-planar diffusion-weighted magnetic resonance (MR) imaging (epiDWI) in differentiating various types of primary parotid gland tumors. In 136 patients, a primary parotid gland tumor was confirmed by histology. Among the observers, a high correlation was calculated (0.98). Apparent diffusion coefficients (ADCs) values of pleomorphic adenomas were significantly higher than those of all other entities, except for myoepithelial adenomas (P = .054). ADC values of Warthin tumors were different from those of myoepithelial adenomas, lipomas, and salivary duct carcinomas (P < .001, 0.013, and .037, respectively). Mucoepidermoid carcinomas, acinic cell carcinomas, and basal cell adenocarcinomas were not differentiable from Warthin tumors (P = .094, .396, and .604, respectively). 2
88. Capaccio P, Cuccarini V, Ottaviani F, et al. Comparative ultrasonographic, magnetic resonance sialographic, and videoendoscopic assessment of salivary duct disorders. Ann Otol Rhinol Laryngol. 2008;117(4):245-252. Observational-Dx 24 patients To compare the it with sialoendoscopy in evaluating stenoses and sialectasia in 24 patients with obstructive symptoms and ultrasonographic results negative for calculi or masses. Ultrasonography and color Doppler ultrasonography showed duct dilatation in all patients (bilateral in 5 with parotid stenosis). Magnetic resonance sialography confirmed duct dilatation and stenosis in all of the patients, and revealed the simultaneous presence of calculi in 4 cases. A parotid sialocele was found in 4 cases. The magnetic resonance sialographic findings were confirmed in the patients who underwent sialoendoscopy. No side effects were observed. 3
89. Onkar PM, Ratnaparkhi C, Mitra K. High-frequency ultrasound in parotid gland disease. Ultrasound Q. 2013;29(4):313-321. Review/Other-Dx N/A To review High-frequency ultrasound in parotid gland disease. No results stated in abstract. 4
90. Rzepakowska A, Osuch-Wojcikiewicz E, Sobol M, Cruz R, Sielska-Badurek E, Niemczyk K. The differential diagnosis of parotid gland tumors with high-resolution ultrasound in otolaryngological practice. Eur Arch Otorhinolaryngol. 2017;274(8):3231-3240. Observational-Dx 72 patients To define the utility of ultrasound (US) in differentiating benign from malignant parotid tumors as well as pleomorphic adenomas (PA) from monomorphic adenoma (MA). The sensitivity, specificity, and accuracy of US in differentiation of malignant from benign lesions in the parotid gland were 60, 95.2, and 90.3%, respectively. The predictive values were: positive predictive value (PPV) 66.8% and negative predictive value (NPV) 93.6%. Differentiating diagnoses between PA and MA with US resulted in a sensitivity of 61.5%, specificity of 81.5%, and accuracy of 73.1%. The predictive values were: PPV 50% and NPV 68.8%, respectively. For distinguishing malignant from benign tumors, the highest AUC values noted were for heterogeneity and vascularization (0.8 and 0.743, respectively). The Area under the curve (AUC) values were the highest for hypoechogenicity and vascularization in separating PA from MA (0.718 and 0.685, respectively). 3
91. Fischer T, Paschen CF, Slowinski T, et al. Differentiation of parotid gland tumors with contrast-enhanced ultrasound. Rofo. 2010;182(2):155-162. Observational-Dx 27 patients To evaluate a new ultrasound (US) technique for differentiating parotid cystadenolymphoma (CL) from pleomorphic adenoma (PA). Histology demonstrated cystadenolymphoma in 9 cases (CL group) and pleomorphic adenoma in 9 (PA group). The intratumoral time-to-peak in the PA group was markedly longer than in the CL group (26.8 +/- 11.1 sec versus 22.6 +/- 5.1 sec, p < 0.05). AUC analysis for the tumor area demonstrated a significant difference between the PA group (30.3 +/- 24.3 dB/area) and the CL group (77.4 +/- 45.6 dB/area, p < 0.05). 3
92. Klotz LV, Ingrisch M, Eichhorn ME, et al. Monitoring parotid gland tumors with a new perfusion software for contrast-enhanced ultrasound. Clin Hemorheol Microcirc. 2014;58(1):261-269. Observational-Dx 33 patients To further analyse the perfusion in parotid gland lesions with Contrast enhanced ultrasound (CE-US). Significant difference of area below intensity time curve (AUC), peak enhancement (PE), wash-in-rate (WiR) and wash-in perfusion index (WiPI) were observed in the malign lesions compared to benign tumors (p < 0,05) and in pleomorphic adenoma compared to cystadenolymphoma (p < 0,05). 3
93. Matsuzuka T, Suzuki M, Saijo S, et al. Stiffness of salivary gland and tumor measured by new ultrasonic techniques: Virtual touch quantification and IQ. Auris Nasus Larynx. 2015;42(2):128-133. Observational-Dx 38 patients To evaluate normal salivary gland stiffness and compare the diagnostic performance of virtual touch quantification (VTQ) and virtual touch imaging quantification (VTIQ) for head and neck tumor. The mean values of VTQ and VTIQ for the normal salivary group (NSG) were 1.92 and 2.06m/s, respectively. The VTQ and VTIQ values were correlative, and there were no statistical differences in each mean value between the normal parotid glands and submandibular glands. For the benign tumor group (BTG), four of the 11 values were non-numeric and were considered above the measurable range. The mean VTIQ value for the BTG was 4.24m/s. For the malignant tumor group (MTG), all four VTQ values were non-numeric. The mean VTIQ value for the MTG was 6.52m/s. For the mean VTIQ values, significant differences were observed among the three groups. The optimum VTQ cutoff value to detect malignant tumors was above the measurable range, and that of VTIQ was 4.83m/s. 3
94. Strieth S, Siedek V, Rytvina M, Gurkov R, Berghaus A, Clevert DA. Dynamic contrast-enhanced ultrasound for differential diagnosis of submandibular gland disease. Eur Arch Otorhinolaryngol. 2014;271(1):163-169. Observational-Dx 30 patients To evaluate feasibility to distinguish different entities of submandibular gland disease including inflammatory alterations of the submandibular gland as well as benign and malignant tumors. Visual analog scales (VAS) data documented significantly less complaints only in benign tumors compared with the other pathologies of the submandibular gland. In parallel, contrast enhanced ultrasound (CEUS)-derived Intensity-time gradients (ITGs) revealed significantly reduced ITGs only in benign tumors (n = 5) compared to the controls (n = 18). Despite of comparably reduced wash-in velocities in malignant lesions (n = 3) statistical significance was not reached. Chronic sialadenitis (n = 18) and its sclerosing variant (Kuttner tumor, n = 4) revealed comparable ITGs as controls. Tumors of the submandibular gland present with reduced functional microcirculatory networks comparing with healthy gland controls and chronically inflamed submandibular glands. 3
95. Brown RE, Harave S. Diagnostic imaging of benign and malignant neck masses in children-a pictorial review. Quant Imaging Med Surg. 2016;6(5):591-604. Review/Other-Dx N/A To review Diagnostic imaging of benign and malignant neck masses in children. No results stated in abstract. 4
96. Lee DY, Seok J, Kim YJ, Kim MS, Sung MW, Hah JH. Neck computed tomography in pediatric neck mass as initial evaluation in ED: is it malpractice? Am J Emerg Med. 2014;32(10):1237-1240. Observational-Dx 105 pediatric patients To evaluate the diagnostic effectiveness of and proper patient selection for neck CT as a method for the initial evaluation of pediatric neck masses in the emergency department. The median age was 6.5 years (1 month to 12 years), and the male-to-female ratio was 2:1. The most common initial impression was acute cervical lymphadenopathy. A comparison of the final diagnosis and CT scan demonstrated that the overall PPV was 96.2%. If the initial impression was a deep neck infection, a salivary gland infection, or tonsillitis, the PPV for CT was 100%. Fever (>38.0 degrees C) and severe tenderness were significant between patients with and without urgent surgical conditions on CT. 3
97. Baker LL, Dillon WP, Hieshima GB, Dowd CF, Frieden IJ. Hemangiomas and vascular malformations of the head and neck: MR characterization. AJNR Am J Neuroradiol. 1993;14(2):307-314. Review/Other-Dx 20 patients To characterize the magnetic resonance (MR) appearance of the common hemangioma of infancy as well as low- and high-flow vascular malformations of the head and neck. Deep hemangiomas and venous malformations demonstrate intermediate signal in T1-weighted images, heterogeneous high signal on T2-weighted images, and prominent enhancement. Involuting hemangiomas show focal areas of high signal intensity on T1-weighted images due to fatty replacement. Venous malformations may demonstrate venous lakes seen as homogeneous regions of high signal intensity on T2-weighted images and phleboliths seen as low signal foci. The one patient with lymphatic malformation showed a large multicystic submandibular mass with large hemorrhage-fluid levels. Features of high-flow lesions (AVMs) include serpiginous signal voids, absence of a dominant mass, and intraosseous extension with decreased marrow signal on T1-weighted images. Invasive combined vascular malformations showed serpiginous flow voids and infiltrative solid masses. Low-flow lesions (hemangiomas, venous, and lymphatic malformations) demonstrate distinct MR findings allowing their differentiation from high-flow lesions (AVMs). Deep hemangiomas and venous malformations appear as solid masses and may look identical. Venous lakes and phleboliths are features of venous malformations which, when present, may help in diagnosis. Combined vascular malformations share features of both low- and high-flow malformations. 4
98. Fordham LA, Chung CJ, Donnelly LF. Imaging of congenital vascular and lymphatic anomalies of the head and neck. Neuroimaging Clin N Am. 2000;10(1):117-136, viii. Review/Other-Dx N/A To review the Imaging of congenital vascular and lymphatic anomalies of the head and neck No results stated in abstract. 4
99. Kollipara R, Dinneen L, Rentas KE, et al. Current classification and terminology of pediatric vascular anomalies. AJR Am J Roentgenol. 2013;201(5):1124-1135. Review/Other-Dx N/A To review new terminology to diagnose, classify, and refer patients with vascular anomalies for additional imaging, intervention, and treatment. No results stated in abstract. 4
100. Donnelly LF, Adams DM, Bisset GS, 3rd. Vascular malformations and hemangiomas: a practical approach in a multidisciplinary clinic. AJR Am J Roentgenol. 2000;174(3):597-608. Review/Other-Dx N/A To review the Vascular malformations and hemangiomas. No results stated in abstract 4
101. LaPlante JK, Pierson NS, Hedlund GL. Common pediatric head and neck congenital/developmental anomalies. Radiol Clin North Am. 2015;53(1):181-196. Review/Other-Dx N/A To discuss on several of the common and sometimes challenging pediatric head and neck congenital/developmental anomalies physicians may encounter in clinical practice. No results stated in abstract. 4
102. Hohlweg-Majert B, Metzger MC, Voss PJ, Holzle F, Wolff KD, Schulze D. Preoperative cervical lymph node size evaluation in patients with malignant head/neck tumors: comparison between ultrasound and computer tomography. J Cancer Res Clin Oncol. 2009; 135(6):753-759. Observational-Dx 45 patients To compare US and CT in preoperative cervical lymph node size evaluation of patients with malignant head/neck tumors. 624 lymph nodes were detected, 64 of which were malignant. Most of the transformed lymph nodes were found in level IIa, II b and III. A more precise measurement was given using US. The correct positive rate of sonographically detected malignant lymph nodes was significantly higher compared to the CT reading. Cervical lymph node staging can be performed safely by US. It is a cheap, easy-to-handle and cost-effective diagnostic method. However, only the uppermost regions of the neck are accessible with a linear transducer. Despite this restriction, US is a reliable and valuable tool for screening lymph nodes in the case of a head or neck malignancy. 3
103. Wong KT, Lee YY, King AD, Ahuja AT. Imaging of cystic or cyst-like neck masses. Clin Radiol. 2008; 63(6):613-622. Review/Other-Dx N/A Review imaging of cystic or cyst-like neck tumors. US is the preferred method for imaging neck tumors. MRI or CT provides supplementary information for large deep-seated lesions. 4
104. Scholbach T, Scholbach J, Krombach GA, Gagel B, Maneschi P, Di Martino E. New method of dynamic color doppler signal quantification in metastatic lymph nodes compared to direct polarographic measurements of tissue oxygenation. Int J Cancer. 2005; 114(6):957-962. Observational-Dx 24 patients examined with color duplex US; 17 patients with polarography To examine role of a new method of dynamic color Doppler signal quantification in metastatic lymph nodes compared to direct polarographic measurements of tissue oxygenation. Percentage of nodal fraction with <10 mm Hg oxygen saturation was significantly inversely correlated with lymph node perfusion (r=0.551; P=0.021). Nodes with a perfusion of <0.05 cm/sec flow velocity showed significantly larger hypoxic areas (P=0.006).The new method allows a noninvasive and quantitative assessment of tumor and metastatic lymph node perfusion by means of commonly available US equipment. 3
105. Collins B, Stoner JA, Digoy GP. Benefits of ultrasound vs. computed tomography in the diagnosis of pediatric lateral neck abscesses. Int J Pediatr Otorhinolaryngol. 2014;78(3):423-426. Observational-Dx 132 patients To assess the accuracy of ultrasound and computed tomography in the same population of pediatric patients with lateral neck abscesses. In children undergoing incision and drainage, the prevalence of an abscess was 89%. Ultrasound has a high specificity (100%) but a low sensitivity (53%). The positive predictive value (96%) is high while the negative predictive value is low (16%), assuming a positive abscess prevalence of 0.9. In contrast, CT has low specificity (18%) but slightly higher sensitivity (68%) compared to ultrasound. Similar to ultrasound, CT had low negative (6%) and high positive (88%) predictive values. 3
106. American College of Radiology. ACR Appropriateness Criteria® Radiation Dose Assessment Introduction. Available at: Review/Other-Dx N/A To provide guidelines on exposure of patients to ionizing radiation. No abstract available. 4