Accuracy of ultrasound in the diagnosis of salivary gland tumors: an integrative review




Ultrasonography; Salivary Gland Neoplasms; Diagnosis.


Salivary gland tumors, although uncommon, are not uncommon. Given its location, it is difficult to correctly diagnose these pathological changes only with the use of clinical examination. Complementary exams such as ultrasonography (US) should be used, which must be safe and accurate. Thus, the aim of this study was to describe the accuracy of US for the diagnosis of salivary gland tumors compared to histopathological evaluation. This is an integrative review. Searches were carried out in the PUBMED/MEDLINE, Scopus and Embase databases, using the following descriptors in English: “ultrasonography/ultrasound”; “salivary glands”; “lesions”; “cyst” and “tumour”. Six articles published from 2015 to 2017. It was verified that the main salivary gland tumors identifiable by means of US are pleomorphic adenoma and Warthin's tumor and that these mainly affect the parotid gland. Studies showed mean accuracy values ​​ranging from 73.1% to 93.4%, sensitivity from 60% to 80%, specificity from 76.9% to 92.0%. Characteristics such as lesion size, echogenicity, regularity of the margin and vascularity were mentioned as standard for diagnosis of lesions. Thus, US is a promising resource for the diagnosis of salivary gland tumors, since it is an accurate imaging test compared to histopathological examination, non-invasive, painless and with high specificity in soft tissues. However, it is operator-dependent and the professional's experience can influence the interpretation of images.


Bagewadi, S. B., Mahima, V. G., & Patil, K. (2010). Ultrasonography of swellings in orofacial region. Journal of Indian Academy of Oral Medicine and Radiology, 22(1), 18.

Bozzato, A., Zenk, J., Greess, H., Hornung, J., Gottwald, F., Rabe, C., & Iro, H. (2007). Potential of ultrasound diagnosis for parotid tumors: analysis of qualitative and quantitative parameters. Otolaryngology—Head and Neck Surgery, 137(4), 642-646.

Carlson, E. R., & Ord, R. (2009). Textbook and color atlas of salivary gland pathology: diagnosis and management. John Wiley & Sons.

Dancey, C., Reidy, J., & Rowe, R. (2012). Statistics for the health sciences: a non-mathematical introduction. Sage Publications.

de Moura, M. M., de Andrade Rufino, R., & Tucunduva, M. J. A. (2019). Referenciais ósseos e vasculonervosos para estudo da glândula parótida por ultrassonografia. Revista de Odontologia da Universidade Cidade de São Paulo, 31(2), 125-133.

De Sousa, L. M. M., Firmino, C. F., Marques-Vieira, C. M. A., Severino, S. S. P. & Pestana, H. C. F. C. (2018). Revisões da literatura científica: tipos, métodos e aplicações em enfermagem. Revista Portuguesa de Enfermagem de Reabilitação,1(1), 45-54.

Garg, S., Sunil, M. K., Jindal, S., Trivedi, A., Guru, E. N., & Verma, S. (2017). Ultrasonography as a diagnostic tool in orofacial swellings. Journal of Indian Academy of Oral Medicine and Radiology, 29(3), 200.

Harish, K. (2004). Management of primary malignant epithelial parotid tumors. Surgical Oncology, 13(1), 7-16.

Hugh C.D. Imaging of salivary gland. In: Myers, E. N., & Ferris, R. L. (Eds.). (2007). Salivary gland disorders. Springer Science & Business Media, 17–32, 2007.

Lee, Y. Y. P., Wong, K. T., King, A. D., & Ahuja, A. T. (2008). Imaging of salivary gland tumours. European journal of radiology, 66(3), 419-436.

Li, L. J., Li, Y., Wen, Y. M., Liu, H., & Zhao, H. W. (2008). Clinical analysis of salivary gland tumor cases in West China in past 50 years. Oral oncology, 44(2), 187-192.

Liu, Y., Li, J., Tan, Y. R., Xiong, P., & Zhong, L. P. (2015). Accuracy of diagnosis of salivary gland tumors with the use of ultrasonography, computed tomography, and magnetic resonance imaging: a meta-analysis. Oral surgery, oral medicine, oral pathology and oral radiology, 119(2), 238-245.

Lowe, L. H., Stokes, L. S., Johnson, J. E., Heller, R. M., Royal, S. A., Wushensky, C., & Hernanz-Schulman, M. (2001). Swelling at the angle of the mandible: imaging of the pediatric parotid gland and periparotid region. Radiographics, 21(5), 1211-1227.

Mansour, N., Stock, K. F., Chaker, A., Bas, M., & Knopf, A. (2012). Evaluation of parotid gland lesions with standard ultrasound, color duplex sonography, sonoelastography, and acoustic radiation force impulse imaging–a pilot study. Ultraschall in der Medizin-European Journal of Ultrasound, 33(03), 283-288.

Marotti, J., Heger, S., Tinschert, J., Tortamano, P., Chuembou, F., Radermacher, K., & Wolfart, S. (2013). Recent advances of ultrasound imaging in dentistry–a review of the literature. Oral surgery, oral medicine, oral pathology and oral radiology, 115(6), 819-832.

Matsuda, E., Fukuhara, T., Donishi, R., Kawamoto, K., Hirooka, Y., & Takeuchi, H. (2017). Usefulness of a novel ultrasonographic classification based on Anechoic area patterns for differentiating Warthin tumors from pleomorphic adenomas of the parotid gland. Yonago Acta Medica, 60(4), 220-226.

Mossel, E., Delli, K., van Nimwegen, J. F., Stel, A. J., Kroese, F. G., Spijkervet, F. K., ... & Bootsma, H. (2017). Ultrasonography of major salivary glands compared with parotid and labial gland biopsy and classification criteria in patients with clinically suspected primary Sjögren’s syndrome. Annals of the Rheumatic Diseases, 76(11), 1883-1889.

Neville, B. W., & Damm, D. D. (2016). Patologia das glândulas salivares. In: Patologia Oral & Maxilofacial. 2. ed. Rio de Janeiro: Editora Guanabara Koogan.

Obuchowski, N. A., & McCLISH, D. K. (1997). Sample size determination for diagnostic accuracy studies involving binormal ROC curve indices. Statistics in Medicine, 16(13), 1529-1542.

Petrovan, C., Nekula, D. M., Mocan, S. L., Voidăzan, T. S., & Coşarcă, A. D. I. N. A. (2015). Ultrasonography-histopathology correlation in major salivary glands lesions. Rom J Morphol Embryol, 56(2), 491-497.

Poul, J. H. K., Brown, J. E., & Davies, J. (2008). Retrospective study of the effectiveness of high-resolution ultrasound compared with sialography in the diagnosis of Sjogren's syndrome. Dentomaxillofacial Radiology, 37(7), 392-397.

Rzepakowska, A., Osuch-Wójcikiewicz, E., Sobol, M., Cruz, R., Sielska-Badurek, E., & Niemczyk, K. (2017). The differential diagnosis of parotid gland tumors with high-resolution ultrasound in otolaryngological practice. European Archives of Oto-Rhino-Laryngology, 274(8), 3231-3240.

Shimizu, M., Ussmüller, J., Hartwein, J., Donath, K., & Kinukawa, N. (1999). Statistical study for sonographic differential diagnosis of tumorous lesions in the parotid gland. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 88(2), 226-233.

Subhashraj, K. (2008). Salivary gland tumors: a single institution experience in India. British Journal of Oral and Maxillofacial Surgery, 46(8), 635-638.

Wong, D. S. (2001). Signs and symptoms of malignant parotid tumours: an objective assessment. Journal of the Royal College of Surgeons of Edinburgh, 46(2), 91-95.

Zajkowski, P., Jakubowski, W., Białek, E. J., Wysocki, M., Osmólski, A., & Serafin-Król, M. (2000). Pleomorphic adenoma and adenolymphoma in ultrasonography. European Journal of Ultrasound, 12(1), 23-29.



How to Cite

CARVALHO-BUONOCORE, H. L. C. C. de; FRAGA, I. M. L.; LOPES, I. A.; LOPES, I. A. Accuracy of ultrasound in the diagnosis of salivary gland tumors: an integrative review. Research, Society and Development, [S. l.], v. 11, n. 10, p. e514111033087, 2022. DOI: 10.33448/rsd-v11i10.33087. Disponível em: Acesso em: 2 dec. 2022.



Health Sciences