The efficacy of a reporting and data system for computed tomography imaging in assessing the likelihood of malignancy in submandibular salivary gland tumors: a preliminary study.
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OBJECTIVE: To establish a submandibular gland imaging reporting and data system (SI-RADS) and explore its value in diagnosing submandibular gland (SMG) tumors. STUDY DESIGN: Patients with primary SMG tumors who underwent enhanced computed tomography (CT) scanning and surgical intervention at Peking University Hospital of Stomatology (2013-2022) were retrospectively included. The imaging data were assessed for acquisition of the relevant imaging features, including lesion boundary, shape, enhancement, calcification, lymph node, and adjacent tissue involvement, and vascular invasion. Thereafter, these lesions were categorized into 6 grades: RADS 1, normal; RADS 2, benign; RADS 3, probably benign; RADS 4a, low probability of malignancy; RADS 4b, moderate probability of malignancy; RADS 5, high probability of malignancy. RESULTS: In total, 336 SMG lesions (272 benign and 64 malignant) were included. The proportions of malignant tumors were 0%, 5.1%, 33.3%, 63.0%, and 100% for SI-RADS 2, 3, 4a, 4b, and 5 lesions, respectively. With an increase in SI-RADS grading, the proportion of malignancy increased significantly. Significant differences in malignancy proportions were observed between adjacent grades. CONCLUSIONS: The SI-RADS based on enhanced CT images exhibits significant importance for preoperative differentiation between benign and malignant SMG tumors. By precisely delineating the imaging characteristics, it provides clinicians with a tool for more accurate preoperative diagnosis and treatment planning.