FDG PET in detecting primary and recurrent malignant salivary gland tumors.
OBJECTIVE
The aim of this study was to assess the role of PET in the management of patients with primary malignant salivary gland (SG) tumor.


METHODS
Sixty-one FDG PET studies in 48 patients (median age 58, range 28-89 years, 20 female, 28 male) who were diagnosed with malignant SG tumors were retrospectively analyzed. Thirteen were referred for initial diagnosis and staging while there was a suspicion of recurrence and/or metastatic disease in 48 patients during the follow-up period.


RESULTS
On PET examinations of 13 patients on initial presentation, 12 showed increased uptake in the primary lesion, while conventional methods (CT, MRI) were positive in 11 and were equivocal for 2 patients. Six patients with multiple nodal and 2 patients with distant metastases were detected by PET. Conventional methods demonstrated lymph node metastases in 5 of these patients. In the follow-up patient group, PET was inaccurate (false-negative or positive) in 4 (8%) patients with local recurrence, and in 4 (8%) with metastatic disease. However, 15 (31%) studies for recurrence and 7 (15%) for metastasis were false-negative with conventional radiologic methods. The sensitivity, specificity, and positive and negative predictive values for the detection of recurrent disease were 83%, 93%, 63%, and 98% for PET; 67%, 69%, 24%, and 94% for conventional methods, respectively. Overall sensitivity, specificity, positive and negative predictive values of PET for detecting metastatic disease were 93%, 96%, 82%, and 99%, while those of conventional methods were 80%, 95%, 75%, and 96%, respectively.


CONCLUSIONS
These results demonstrate that FDG PET is not only superior to CT and/or MRI for staging at the initial presentation but also superior to conventional imaging methodologies for detecting local recurrence and regional lymph node and distant metastases in patients with malignant SG tumor.
Cermik
Tevfik Fikret
TF
Department of Radiology, Division of Nuclear Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
Mavi
Ayse
A
Acikgoz
Gunsel
G
Houseni
Mohamed
M
Dadparvar
Simin
S
Alavi
Abass
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012468:Salivary Gland Neoplasms / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18