Nucl Med Mol Imaging.  2009 Oct;43(5):395-401.

(18)F-FDG PET/CT in Patients with Initially Diagnosed Adenoid Cystic Carcinoma of the Head and Neck: Clinicoplathologic Correlation

• Lee JY
• Choi JY
• Ko YH
• Baek CH
• Son YI
• Cho SK
• Cheon M
• Lee KH
• Kim BT

Abstract

PURPOSE
We evaluated (18)F-FDG PET/CT findings in initially diagnosed adenoid cystic carcinoma (ACC) of the head and neck in association with pathological subtype, staging, uptake comparison with squamous cell carcinoma (SqCC) and prognosis.
MATERIALS AND METHODS
The subjects were 16 patients with initially diagnosed ACC of head and neck who underwent pretreatment (18)F-FDG PET/CT. Histological subtype (solid pattern vs. tubular/cribriform pattern), SUV(max) of size-matched SqCC of the head and neck as control group, disease-free survival (DFS) were compared with the SUV(max) of ACC of the head and neck.
RESULTS
Of total 16 patients, 6 had solid pattern and the remaining 10 had tubular/cribriform pattern. The SUV(max) were significantly higher in solid pattern group than in tubular/cribriform pattern group (6.7+/-3.2 vs. 4.2+/-0.9, p=0.03). PET/CT found unexpected distant metastasis in 18.7% of patients (3/16) and changed the therapeutic plan in those patients. The SUV(max) of ACC was significantly lower than that of size-matched SqCC (5.1+/-2.4 vs. 13.6+/-6.0, p<0.001). DFS was not significantly different according to the histological subtype. In contrast, patients with high (18)F-FDG uptake (SUV(max) > or =6.0) had significantly shorter DFS than those with low (18)F-FDG uptake (SUV(max) <6.0).
CONCLUSION
(18)F-FDG uptake of ACC of the head and neck is significantly associated with histological subtype and DFS. (18)F-FDG PET/CT may be useful for detecting unexpected metastasis. Since (18)F-FDG uptake of tubular/cribriform ACC compared with SqCC is relatively low, it is necessary to interpret PET images carefully in patients without alleged ACC.

Keyword

PET/CT; (18)F-FDG; adenoid cystic carcinoma; head and neck; prognosis

MeSH Terms

Adenoids
Carcinoma, Adenoid Cystic
Carcinoma, Squamous Cell
Disease-Free Survival
Head
Humans
Neck
Neoplasm Metastasis
Prognosis