Nucl Med Mol Imaging.  2013 Dec;47(4):242-248.

The Value of F-18 FDG PET for Planning Treatment and Detecting Recurrence in Malignant Salivary Gland Tumors: Comparison with Conventional Imaging Studies

Affiliations
  • 1Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. iryoo@catholic.ac.kr

Abstract

PURPOSE
To assess the value of F-18 FDG PET/CT for detecting cervical lymph node (LN) metastasis and recurrence, as well as planning treatment, and to compare the accuracy of PET/CT with conventional imaging studies (CIS) in patients with malignant salivary gland tumor (SGT).
METHODS
Staging and follow-up PET/CT for SGT were retrospectively reviewed. Enhanced CT and/or MRI of the neck were performed within 1 month of PET/CT. Final diagnosis was based on histology from cervical LN dissection and biopsy or a minimum 6 months of clinical and imaging follow-up. We compared the performance of PET/CT in initial cervical LN staging and recurrence detection with that of CIS.
RESULTS
A total of 184 PET/CT exams of 66 patients were included, and 34 initial staging and 150 surveillance PET/CT exams were performed. The initial cervical LN detection sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 60.9 %, 89.2 %, 84.0 %, 56.0 %, and 91.0 % for visual analysis on PET/CT, 39.1 %, 95.0 %, 84.8 %, 64.3 %, and 87.4 % for semiquantitative analysis on PET/CT, and and 43.5 %, 94.1 %, 84.8 %, 62.5 %, and 88.1 % for CIS. The sensitivity of visual analysis on PET/CT was significantly higher than that of semiquantitative analysis on PET/CT and CIS (p=0.0009 and 0.0086). In 5 of 34 initial staging patients (14.7 %), the treatment plan was changed from curative surgery to palliative therapy. The performance of follow-up PET/CT showed no significant difference compared with CIS.
CONCLUSION
PET/CT showed comparable performance with CIS for cervical LNs staging. Initial PET/CT changed treatment plans in 14.7 % of patients. However, PET/CT offered no additional advantage for detecting locoregional recurrence.

Keyword

Salivary gland neoplasm; F-18 FDG PET/CT; Cervical lymph nodes; Staging

MeSH Terms

Biopsy
Diagnosis
Follow-Up Studies
Humans
Lymph Nodes
Magnetic Resonance Imaging
Neck
Neoplasm Metastasis
Palliative Care
Positron-Emission Tomography and Computed Tomography
Recurrence*
Retrospective Studies
Salivary Gland Neoplasms
Salivary Glands*
Sensitivity and Specificity
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