Utility of 18F-FDG PET/CT for Detecting Neck Metastasis in Patients with Salivary Gland Carcinomas: Preoperative Planning for Necessity and Extent of Neck Dissection
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
The precise diagnosis of cervical lymph node metastasis (CLNM) of salivary gland cancer is important to determine the surgical extent and adjuvant therapy. This study assessed the clinical utility of 18F-FDG PET in identifying CLNM in such patients.
Fifty-four patients with intermediate or high-grade salivary gland cancer were preoperatively evaluated with 18F-FDG PET/CT and CT/MRI. Histopathologic analysis of neck dissection tissues was used as the gold standard for assessing imaging techniques. Tumor and nodal maximum standardized uptake values (SUVmax) were measured for each patient. Univariate and multivariate analyses were used to identify CLNM predictive factors.
Of the 54 patients, 24 patients (44 %) had CLNM. On a per-patient basis, the sensitivity and specificity of 18F-FDG PET/CT and CT/MRI were not significantly different (92 vs. 83 %, P = 0.625 and 93 vs. 97 %, P = 1.000, respectively). On a per-level basis, 18F-FDG PET/CT was significantly more sensitive and accurate than CT/MRI in the ipsilateral neck (96 vs. 54 %, P < 0.001 and 92 vs. 83 %, P < 0.001, respectively). The mean nodal SUVmax values of patients with and without nodal metastasis were 4.9 and 2.1, respectively (P = 0.008). Histologic grade was a significant predictor of CLNM (P = 0.014, odds ratio 14.46, 95 % confidence interval 1.73–120.79).
18F-FDG PET/CT imaging and histologic grade are useful for detecting CLNM in patients with salivary gland carcinoma. This finding may guide preoperative planning for the necessity and extent of neck dissection in these patients.
- Pinkston JA, Cole P. Incidence rates of salivary gland tumors: results from a population-based study. Otolaryngol Head Neck Surg. 1999;120:834–40. CrossRef
- Spiro RH. Salivary neoplasmas: overview of a 35-year experience with 2,807 patients. Head Neck Surg. 1986;8:177–84. CrossRef
- Kokemueller H, Swennen G, Brueggemann N, Brachvogel P, Eckardt A, Hausamen JE. Epithelial malignancies of the salivary glands: clinical experience of a single institution—a review. Int J Oral Maxillofac Surg. 2004;33:423–32. CrossRef
- Lima RA, Travares MR, Dias FL, Kligerman J, Nascimento MF, Barbosa MM, et al. Clinical prognostic factors in malignant parotid gland tumors. Otolaryngol Head Neck Surg. 2005;133:702–8. CrossRef
- Stennert E, Kisner D, Jungehuelsing M, Guntinas-Lichius O, Schröder U, Eckel HE, et al. High incidence of lymph node metastasis in major salivary gland cancer. Arch Otolaryngol Head Neck Surg. 2003;129:720–3. CrossRef
- Armstrong JG, Harrison LB, Thaler HT, Friedlander-Klar H, Fass DE, Zelefsky MJ, et al. The indications for elective treatment of the neck in cancer of the major salivary glands. Cancer. 1992;69:615–9. CrossRef
- Korkmaz H, Yoo GH, Du W, Hocwald E, Otero-Garcia JE, Volkan Adsay N, et al. Predictors of nodal metastasis in salivary gland cancer. J Surg Oncol. 2002;80:186–9. CrossRef
- Rodriguez-Cuevas S, Labastida S, Baena L, Gallegos F. Risk of nodal metastases from malignant salivary gland tumors related to tumor size and grade of malignancy. Eur Arch Otorhinolaryngol. 1995;252:139–42.
- Bhattacharyya N, Fried MP. Nodal metastasis in major salivary gland cancer: predictive factors and effects on survival. Arch Otolaryngol Head Neck Surg. 2002;128:904–8.
- Kim KH, Sung MW, Yun JB, Han MH, Baek CH, Chu KC, et al. The significance of CT scan or MRI in the evaluation of salivary gland tumors. Auris Nasus Larynx. 1998;25:397–402. CrossRef
- Thoeny HC. Imaging of salivary gland tumours. Cancer Imaging. 2007;7:52–62. CrossRef
- Burke CJ, Thomas RH, Howlett D. Imaging the major salivary glands. Br J Oral Maxillofac Surg. 2011;49:261–9. CrossRef
- Roh JL, Ryu CH, Choi SH, Kim JS, Lee JH, Cho KJ, et al. Clinical utility of 18F-FDG PET for patients with salivary gland malignancies. J Nucl Med. 2007;48:240–6.
- Jeong HS, Chung MK, Son YI, Choi JY, Kim HJ, Ko YH, et al. Role of 18F-FDG PET/CT in management of high-grade salivary gland malignancies. J Nucl Med. 2007;48:1237–44. CrossRef
- Razfar A, Heron DE, Branstetter BF IV, Seethala RR, Ferris RL. Positron emission tomography–computed tomography adds to the management of salivary gland malignancies. Laryngoscope. 2010;120:734–8. CrossRef
- Branstetter BF, Blodgett TM, Zimmer LA, Snyderman CH, Johnson JT, Raman S, et al. Head and neck malignancy: is PET/CT more accurate than PET or CT alone? Radiology. 2005;235:580–6. CrossRef
- Lonneux M, Hamoir M, Reychler H, Maingon P, Duvillard C, Calais G, et al. Positron emission tomography with [18F]fluorodeoxyglucose improves staging and patient management in patients with head and neck squamous cell carcinoma: a multicenter prospective study. J Clin Oncol. 2010;28:1190–5. CrossRef
- Moeller BJ, Rana V, Cannon BA, Williams MD, Sturgis EM, Ginsberg LE, et al. Prospective risk-adjusted [18F]fluorodeoxyglucose positron emission tomography and computed tomography assessment of radiation response in head and neck cancer. J Clin Oncol. 2009;27:2509–15. CrossRef
- Stokkel MP, ten Broek FW, Hordijk GJ, Koole R, van Rijk PP. Preoperative evaluation of patients with primary head and neck cancer using dual-head 18fluorodeoxyglucose positron emission tomography. Ann Surg. 2000;231:229–34. CrossRef
- Hannah A, Scott AM, Tochon-Danguy H, Chan JG, Akhurst T, Berlangieri S, et al. Evaluation of 18F-fluorodeoxyglucose positron emission tomography and computed tomography with histopathologic correlation in the initial staging of head and neck cancer. Ann Surg. 2002;236:208–17. CrossRef
- Ng SH, Yen TC, Chang JT, Chan SC, Ko SF, Wang HM, et al. Prospective study of [18F]fluorodeoxyglucose positron emission tomography and computed tomography and magnetic resonance imaging in oral cavity squamous cell carcinoma with palpably negative neck. J Clin Oncol. 2006;24:4371–6. CrossRef
- Schöder H, Carlson DL, Kraus DH, Stambuk HE, Gönen M, Erdi YE, et al. 18F-FDG PET/CT for detecting nodal metastases in patients with oral cancer staged N0 by clinical examination and CT/MRI. J Nucl Med. 2006;47:755–62.
- Roh JL, Yeo NK, Kim JS, Lee JH, Cho KJ, Choi SH, et al. Utility of 2-[18F]fluoro-2-deoxy-d-glucose positron emission tomography and positron emission tomography/computed tomography imaging in the preoperative staging of head and neck squamous cell carcinoma. Oral Oncol. 2007;43:887–93. CrossRef
- Murakami R, Uozumi H, Hirai T, Nishimura R, Shiraishi S, Ota K, et al. Impact of FDG-PET/CT imaging on nodal staging for head-and-neck squamous cell carcinoma. Int J Radiat Oncol Biol Phys. 2007;68:377–82. CrossRef
- Kim SY, Kim JS, Doo H, Lee H, Lee JH, Cho KJ, et al. Combined [18F]fluorodeoxyglucose positron emission tomography and computed tomography for detecting contralateral neck metastases in patients with head and neck squamous cell carcinoma. Oral Oncol. 2011;47:376–80. CrossRef
- Robbins KT, Shaha AR, Medina JE, Califano JA, Wolf GT, Ferlito A, et al. Committee for Neck Dissection Classification, American Head and Neck Society. Consensus statement on the classification and terminology of neck dissection. Arch Otolaryngol Head Neck Surg. 2008;134:536–8. CrossRef
- Som PM, Curtin HD, Mancuso AA. Imaging-based nodal classification for evaluation of neck metastatic adenopathy. Am J Roentgenol. 2000;174:837–44.
- Scianna JM, Petruzzelli GJ. Contemporary management of tumors of the salivary glands. Curr Oncol Rep. 2007;9:134–8. CrossRef
- Adelstein DJ, Rodriguez CP. What is new in the management of salivary gland cancers? Curr Opin Oncol. 2011;23:249–53. CrossRef
- Barnes L, Eveson JW, Reichart P, Sidransky D. World Health Organization classification of tumours: pathology and genetics. Head and neck tumours. Lyon: IARC Press; 2005.
- Fukui MB, Blodgett TM, Snyderman CH, Johnson JJ, Myers EN, Townsend DW, et al. Combined PET-CT in the head and neck: part 2. Diagnostic uses and pitfalls of oncologic imaging. Radiographics. 2005;25:913–30. CrossRef
- Kuntz AL, Weymuller EA Jr. Impact of neck dissection on quality of life. Laryngoscope. 1999;109:1334–8. CrossRef
- Laverick S, Lowe D, Brown JS, Vaughan ED, Rogers SN. The impact of neck dissection on health-related quality of life. Arch Otolaryngol Head Neck Surg. 2004;130:149–54. CrossRef
- van Wilgen CP, Dijkstra PU, van der Laan BF, Plukker JT, Roodenburg JL. Shoulder and neck morbidity in quality of life after surgery for head and neck cancer. Head Neck. 2004;26:839–44. CrossRef
- Utility of 18F-FDG PET/CT for Detecting Neck Metastasis in Patients with Salivary Gland Carcinomas: Preoperative Planning for Necessity and Extent of Neck Dissection
Annals of Surgical Oncology
Volume 20, Issue 3 , pp 899-905
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Industry Sectors
- Author Affiliations
- 1. Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- 2. Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- 3. Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- 4. Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- 5. Biomedical Research Institute, Korea Institute of Science and Technology, Seoul, Republic of Korea