Investigation of the potential of shear wave elastography for diagnosis and differential diagnosis of major salivary gland neoplasms

Objective: To investigate the stiffness indices of normal submandibular (SMG) and parotid (PG) salivary glands using two-dimensional (2D-SWE) and point (pSWE) shear wave elastography, and to assess the diagnostic capabilities of shear wave elastography in the differential diagnosis of major salivary gland (MSG) neoplasms.

Material and methods: A retrospective analysis of medical data was performed in 51 volunteers with normal PG and SMG (Group 1) and 77 patients with tumors of the PG and SMG (Group 2). For 2D-SWE, minimum, median, and maximum values, SD (kPa) were analyzed. For pSWE, median stiffness, median shear modulus, and mean shear modulus (kPa) were evaluated.

Results: Statistically significant differences in parenchymal stiffness of normal PG and SMG (p<0.05) were obtained: the median 2D-SWE for normal PG was 36.83 kPa (Q1-Q3:31.92-44.6), the median for SMG was 29.31 kPa (Q1-Q3:26.39-34.94); SD for PG was 13.55 kPa (Q1-Q3:11.63-18.78), for SMG was 11.53 kPa (Q1-Q3:9.73-12.65); median pSWE for PG was 35.52 kPa (Q1-Q3:32.08-43.84), for SMG was 30.34 kPa (Q1-Q3:26.91-36.20); shear modulus pSWE for PMG was 11.84 kPa (Q1-Q3:10.69-14.62), and for SMG-10.02 kPa (Q1-Q3:8.83-11.34). Comparison of 2D-SWE and pSWE data between subgroups revealed statistically significant differences between normal PG and PC tumors (p=<0.0001 for U=350; p=0.0157 for U=601) and between subgroups 1.2/2.2 (p=<0.0001 for U=17; p=0.032 for U=60). No significant differences were observed in the SD of 2D-SWE between normal PG and PG tumor subgroups (p=0.323), or in the minimum 2D-SWE values between normal SMG and SMG tumor subgroups (p=0.68).

Conclusion: Stiffness values in the normal PG are higher than those in SMG (p<0.05). Stiffness differs significantly between benign and malignant PG tumors (p<0.05). Shear wave elastography is not effective for the differential diagnosis of SMG tumors.

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