# Multiparametric Ultrasound for Preoperative Assessment of Parotid Tumors: A Novel Diagnostic Pathway

## TL;DR

A new ultrasound method combining multiple imaging techniques improves the accuracy of diagnosing parotid gland tumors before surgery.

## Contribution

A novel real-time multiparametric ultrasound approach for preoperative assessment of parotid tumors is introduced and evaluated.

## Key findings

- The mpUS method achieved 83% sensitivity, 94% specificity, and 91% accuracy in diagnosing parotid tumors.
- Contrast-enhanced ultrasound and shear wave elastography provided complementary data for tumor assessment.
- The method outperformed single-modality ultrasound but requires further training and equipment access for broader use.

## Abstract

Accurate preoperative differentiation of parotid gland tumors (PGTs) is essential for facial nerve preservation. This study evaluates a novel, real‐time multiparametric ultrasound (mpUS) approach combining B‐mode, shear wave elastography (SWE), and contrast‐enhanced ultrasound (CEUS), based on qualitative image interpretation.

Eighty‐nine patients with 91 PGTs underwent mpUS prior to surgery or ultrasound‐guided biopsy. Two blinded experts independently reviewed the images and reached consensus through real‐time discussion. Only qualitative features were assessed. Histopathology served as the reference.

mpUS achieved 83% sensitivity (95% CI: 62.6–94.0), 94% specificity (95% CI: 84.3–98.1), and 91% accuracy (95% CI: 82.4–96.3). CEUS and SWE provided complementary perfusion and stiffness data. CCDS was excluded due to limited value.

mpUS improves diagnostic accuracy compared to single‐modality US and supports early, targeted treatment. Limitations include the small number of malignancies, single‐center design, and qualitative evaluation. Broader use may require training and equipment access.