The diagnostic role of ultrasonography, computed tomography, magnetic resonance imaging, positron emission tomography/computed tomography, and real-time elastography in the differentiation of benign and malignant salivary gland tumors: a meta-analysis

Objective. The objective of this study was to assess the diagnostic properties of ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography/computed tomography (PET/CT), and real-time elastography (RTE) in distinguishing between benign and malignant salivary gland tumors. Study Design. English databases were searched for eligible studies. Diagnostic accuracy parameters, including sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver operating characteristic curves (SROC) were calculated. Meta-regression and subgroup analyses were performed to identify the source of heterogeneity. Results. In total, 38 studies were included. Pooled sensitivities for ultrasonography, CT, MRI, PET/CT, and RTE were 0.66, 0.70, 0.80, 0.81, and 0.80, respectively. Pooled specificities were 0.92, 0.73, 0.90, 0.89, and 0.70, respectively. The DORs were 23, 6, 38, 20, and 10, respectively. The areas under the curve (AUC) of SROC for US, CT, MRI, PET/CT, and RTE were 0.91, 0.77, 0.92, 0.88, and 0.82, respectively. Conclusion. Based on the results of the meta-analysis, MRI may be the first choice for the differential diagnosis of benign and malignant salivary gland tumors for its relatively high diagnostic value. PET/CT tends to have greater accuracy than CT. Ultrasonography and RTE may help achieve better diagnostic outcomes if they are used in conjunction.