Carotid body tumor diagnostic study of choice
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2]
Overview
Diagnostic Study of Choice
- The carotid body tumor is diagnosed primarily by history and physical examination.[1]
- Imaging studies are necessary to make the final diagnosis.
- Traditionally, digital subtraction angiography (DSA) has been the golden standard for the diagnosis of carotid body tumor.
- However, DSA has been replaced by other imaging studies such as CT angiography and MR angiography which provides an accurate angiogram as well as information on the local extension of the tumor to the adjacent tissues.[2]
- Color Doppler ultrasound has been recommended as a method of screening for the diagnosis of carotid body tumor.[3]
- This method is useful in the diagnosis of Shamblin’s type and intralesional blood flow of the tumor before the metastasis.[2]
- CT imaging is useful in the diagnosis of local invasion of the tumor to adjacent arteries and skull base.
- This metthod is able to differentiate the tumor from other paragangliomas.[2]
- CT imaging combined with color doppler ultrasound has been suggested as the optimal detection modality for the assessment and management of the tumor.
- Since the tumor is highly vascular, incisional biopsy and percutaneous needle aspiration are contraindicated and it may cause complications such as:[4]
- Massive bleeding
- Pseudoaneurysm formation
- Carotid thrombosis
The comparison of various diagnostic studies for carotid body tumor
| Test | Sensitivity | Specificity | Accuracy |
|---|---|---|---|
| CT angiography | 100% | 100% | 100% |
| Color Doppler ultrasound | 89.8% | 82.6% | 87.5% |
- It is also suggested that CT angiography is more accurate than color Doppler ultrasound for the diagnosis of larger lesions.[2]
- Genetic analysis should be considered for patients with:[5]
- A positive family history
- Presence of multiple paragangliomas
- Those who manifest the tumor before 50 years of age.
Sequence of Diagnostic Studies
- The first line imaging modality for the diagnosis and assessment of the tumor is Color Doppler ultrasound.[2][6]
- CT imaging can be used as the second line modality for the diagnosis of selected cases.[2]
- Second line imaging modality is highly suggested in those with a positive family history and multifocal disease.
Name of Diagnostic Criteria
- There are no established criteria for the diagnosis of carotid body tumor.
References
- ↑ Luo T, Zhang C, Ning YC, Gu YQ, Li JX, Wang ZG (March 2013). "Surgical treatment of carotid body tumor: case report and literature review". J Geriatr Cardiol. 10 (1): 116–8. doi:10.3969/j.issn.1671-5411.2013.01.018. PMC 3627704. PMID 23610583.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 Jin, Zhan-Qiang; He, Wen; Wu, Dong-Fang; Lin, Mei-Ying; Jiang, Hua-Tang (2016). "Color Doppler Ultrasound in Diagnosis and Assessment of Carotid Body Tumors: Comparison with Computed Tomography Angiography". Ultrasound in Medicine & Biology. 42 (9): 2106–2113. doi:10.1016/j.ultrasmedbio.2016.04.007. ISSN 0301-5629.
- ↑ Worsey, M.J.; Laborde, A.L.; Bower, T.; Miller, E.; Kresowik, T.F.; Sharp, W.J.; Corson, J.D. (1992). "An Evaluation of Color Duplex Scanning in the Primary Diagnosis and Management of Carotid Body Tumors". Annals of Vascular Surgery. 6 (1): 90–94. doi:10.1007/BF02000675. ISSN 0890-5096.
- ↑ Mirov, Andrew G. (1962). "Benign and Malignant Carotid Body Tumors". JAMA: The Journal of the American Medical Association. 181 (1): 13. doi:10.1001/jama.1962.03050270015003. ISSN 0098-7484.
- ↑ Davila, Victor J.; Chang, James M.; Stone, William M.; Fowl, Richard J.; Bower, Thomas C.; Hinni, Michael L.; Money, Samuel R. (2016). "Current surgical management of carotid body tumors". Journal of Vascular Surgery. 64 (6): 1703–1710. doi:10.1016/j.jvs.2016.05.076. ISSN 0741-5214.
- ↑ Tong Y (August 2012). "Role of duplex ultrasound in the diagnosis and assessment of carotid body tumour: A literature review". Intractable Rare Dis Res. 1 (3): 129–33. doi:10.5582/irdr.v1.3.129. PMID 25343084.