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Background: Differentiation between benign and malignant parotid tumors before surgery is important because it can change the treatment plan for patients. We evaluated the role of magnetic resonance spectroscopy (MRS) for differentiating benign from malignant parotid tumors. Materials and Methods: Forty patients with salivary gland tumor especially parotid, who were candidate for surgery, were enrolled. Patients were selected in Amiralam Hospital and underwent MRI in Imam Khomeini Hospital in Tehran. Magnetic resonance spectroscopy (MRS) was performed at 135 and 270 time of echo (TE), and the choline/creatine ratio was determined. The cytological results were used to divide the patients into warthin, benign and malignant groups and ROC curves were used to determine the best cut off points. Results: Forty patients entered this study, 25 had benign non-warthin tumors, nine had malignant tumors and six had warthin tumors. TE:136 was stronger for differentiating benign from malignant tumors. The best cutoff point for choline/creatine ratio was 1.92 in TE:136 with a sensitivity of 81% and a specificity of 89% and 1.76 in TE:270 with a sensitivity of 89% and a specificity of 71%. Choline/creatine ratio <1.25 can rule out malignancy with a sensitivity of 92% and ratio > 1.76 strongly suggests malignancy with a specificity of 10%. MRS was not able to differentiate benign non-warthin from warthin tumors. Conclusion: According to the present study, choline/creatine ratio in MRS is a noninvasive method that can be used for differentiating benign from malignant tumors.

ṭibb-i junūb

Diagnostic Value of Magnetic Resonance Spectroscopy in Differentiation of Benign and Malignant Salivary Gland Tumors in Comparison with Pathology Results