Role of 18F-FDG PET/CT in management of high-grade salivary gland malignancies.
The role of 18F-FDG PET/CT for planning the treatment of high-grade salivary gland malignancies was investigated and was compared with that with using contrast-enhanced CT.


METHODS
The subjects chosen for the study had high-grade cancer of the salivary gland, as confirmed by surgical pathology. The diagnostic values from 37 CT and PET/CT scans of 33 subjects were compared. The ability to predict the extent of the disease was compared by performing a subsite-based analysis for the primary lesions and a level-by-level analysis for the neck node levels as well as for the final TNM staging. The surgical pathology (67.6%) and clinical follow-up examinations (32.4%) were used as the reference standards. Furthermore, the changes made in each subject's care, based on a PET/CT examination, were compared with the treatment received without using the PET/CT data.


RESULTS
Using a primary subsite-based analysis, the diagnostic accuracy for predicting the pathologic tumor extent was significantly higher for PET/CT (91.0%) compared with that using CT alone (70.1%, P < 0.001). For the neck nodes on a level-by-level analysis, the metastasis could be predicted more accurately on the basis of a PET/CT examination (97.6%) than with using only CT (86.0%, P = 0.01). PET/CT was also far superior to CT in terms of the TNM staging (83.7% vs. 62.1%, P = 0.03). For 43.2% of the subjects, changes in the clinical decision making were made as a result of the PET/CT scan data over what was previously determined by using the CT scans alone.


CONCLUSIONS
PET/CT provides more accurate diagnostic information for the evaluation of high-grade salivary cancer than does CT and it has a major impact on making treatment decisions for patients with a high-grade salivary malignancy.
Jeong
Han-Sin
HS
Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Chung
Man Ki
MK
Son
Young-Ik
YI
Choi
Joon Young
JY
Kim
Hyung Jin
HJ
Ko
Young Hyeh
YH
Baek
Chung-Hwan
CH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D011856:Radiographic Image Enhancement; D019275:Radiopharmaceuticals; D012468:Salivary Gland Neoplasms / Q000175:diagnosis* / Q000628:therapy; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18