title: Positron emission tomography-computed tomography adds to the management of salivary gland malignancies.
abstract: OBJECTIVE
  To evaluate the efficacy of combined positron emission tomography-computed tomography (PET-CT) in identifying salivary gland malignancies and to examine the role of PET-CT in the management of these patients.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Fifty-five patients with diagnosed salivary gland cancer who had undergone PET-CT scanning were retrospectively reviewed from January 2000 to October 2008. PET-CT scans using intravenous contrast were correlated with clinicopathological information to determine diagnostic accuracy of disease extent. The impact of PET-CT findings on therapeutic management was analyzed. All histopathologic grades were included in the study.
  
  
  RESULTS
  Overall, PET-CT demonstrated a sensitivity of 74.4%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 61.5%. PET-CT also identified unrecognized distant metastases in the following sites: six lung, five bone, two distant lymph nodes, and one liver. PET-CT added to management in 26 patients (47.3%), and it was the deciding diagnostic modality in eight patients (14.5%). Of these 26 patients, 14 patients underwent additional surgery. Three patients with recurrence underwent PET-CT scan-directed radiation and/or chemotherapy, whereas nine patients diagnosed with distant disease received palliative treatment.
  
  
  CONCLUSIONS
  PET-CT is useful for planning the most appropriate treatment by identifying clinically unrecognized disease. PET-CT shows a high diagnostic accuracy for detecting disease recurrence and distant metastases, thus helping to determine whether patients are candidates for potentially curative or palliative treatment.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Razfar
authors.forename: Dwight E
authors.initials: DE
authors.lastname: Heron
authors.forename: Barton F
authors.initials: BF
authors.lastname: Branstetter
authors.forename: Raja R
authors.initials: RR
authors.lastname: Seethala
authors.forename: Robert L
authors.initials: RL
authors.lastname: Ferris
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012468:Salivary Gland Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D012680:Sensitivity and Specificity