Efficacy of computed tomography features in the differentiation of basal cell adenoma and Warthin tumor in the parotid gland

Objective. The aim of this study was to identify computed tomography (CT) features that differentiate basal cell adenoma (BCA) from Warthin tumor (WT). Materials and Methods. Histopathologically confirmed parotid gland tumors (57 BCAs and 83 WTs) were retrospectively reviewed. CT images were evaluated to determine location, distribution, cyst formation, size, the new vessel facing sign (VFS), and enhancement behavior including the CT attenuation of solid portions of the tumor (AST), the vessel near the tumor (AVT), and maxillary artery (AMA) on early stage 2-phase contrast CT. Tumor CT attenuation ratios (AST/AVT and AST/AMA) were calculated. Chi-square tests, independent t-tests, and receiver operating characteristic curve analysis were conducted. Results. Male:female ratio, patient age, posteroinferior location, tumor size, and presence of VFS were significantly lower for BCA than WT. The average AST/AVT was significantly higher for BCA than WT. The threshold value for AST/AVT on early stage 2 phase contrast CT was 0.72 between BCA and WT, and sensitivity and specificity were 94.7% and 98.8%, respectively, as calculated by receiver operating characteristic analysis. Conclusion. Gender ratio, age, location, size, presence of VFS, and AST/AVT value may help to differentiate BCA from WT in parotid glands on CT examination. (Oral Surg Oral Med Oral Pathol Oral Radiol 2021;132:589-596)