Point‐of‐care ultrasound scan as the primary modality for evaluating parotid tumors

OBJECTIVES: This study aimed to explore ultrasonography as a single imaging modality for the initial assessment of parotid lesions compared to computed tomography (CT) and magnetic resonance imaging (MRI). METHODS: A retrospective cross‐sectional study was performed on 264 parotid gland lesions evaluated in a dedicated point‐of‐care ultrasound (POCUS) clinic with concurrent fine needle biopsy (FNB). Two hundred and nine of these lesions also underwent CT or MRI imaging. Histopathology results, when available, were recorded and compared to imaging impressions. RESULTS: Surgeon‐performed POCUS classified parotid masses accurately when compared to final histopathology (90/96, 94%). Using predefined criteria, POCUS determined the nature of parotid lesions more definitively than the descriptive CT or MRI radiology reports (p <.001). Sub‐analysis showed that ultrasonography was able to distinguish between benign pathologies with high degree of accuracy (Warthin tumor—82%, pleomorphic adenoma—64%). CONCLUSIONS: POCUS can accurately distinguish between benign and malignant parotid lesions. POCUS may suffice as the only imaging study for benign lesions, obviating the need for additional cross‐sectional imaging. This can be combined with fine needle or core biopsy in the same visit, resulting in expedient diagnosis, low cost, and lack of radiation exposure. LEVEL OF EVIDENCE: 2b, individual cross‐sectional cohort study.