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Up-front F18-FDG PET/CT in suspected salivary gland carcinoma

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Abstract

Objective

To investigate whether a 18F-FDG PET/CT (PET/CT)-based diagnostic strategy adds decisive new information compared to conventional imaging in the evaluation of salivary gland tumours and the detection of cervical lymph node metastases, distant metastases, and synchronous cancer in patients with salivary gland carcinoma.

Methods

The study was a blinded prospective cohort study. Data were collected consecutively through almost 3 years. All patients underwent conventional imaging—magnetic resonance imaging (MRI) and chest X-ray (CXR)—in addition to PET/CT prior to surgery. Final diagnosis was obtained by histopathology. MRI/CXR and PET/CT were interpreted separately by experienced radiologists and nuclear medicine physicians. Interpretation included evaluation of tumour site, cervical lymph node metastases, distant metastases, and synchronous cancer.

Results

Ninety-one patients were included in the study. Thirty-three patients had primary salivary gland carcinoma and eight had cervical lymph node metastases. With PET/CT, the sensitivity was 92% and specificity 29% regarding tumour site. With MRI/CXR, the sensitivity and specificity were 90% and 26%, respectively. Regarding cervical lymph node metastases in patients with salivary gland carcinoma, the sensitivity with PET/CT was 100% and with MRI/CXR 50%. PET/CT diagnosed distant metastases in five patients, while MRI/CXR detected these in two patients. Finally, PET/CT diagnosed two synchronous cancers, whereas MRI/CXR did not detect any synchronous cancers.

Conclusions

Compared with MRI/CXR PET/CT did not improve discrimination of benign from malignant salivary gland lesions. However, PET/CT may be advantageous in primary staging and in the detection of distant metastases and synchronous cancers.

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Authors and Affiliations

  1. Department of ORL-Head and Neck Surgery and Audiology, Odense University Hospital, J.B. Winsløws Vej 4, 5000, Odense C, Denmark

    Marie Westergaard-Nielsen, Max Rohde, Christian Godballe & Kristine Bjørndal

  2. Department of Pathology, Odense University Hospital, Odense, Denmark

    Stine Rosenkilde Larsen

  3. Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark

    Jesper G. Eriksen

  4. Department of Radiology, Odense University Hospital, Odense, Denmark

    Nina Nguyen, Mie K. Nielsen, Jon T. Asmussen & Anabel Diaz

  5. Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark

    Oke Gerke, Anne L. Nielsen, Anders Thomassen & Poul Flemming Høilund-Carlsen

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  1. Marie Westergaard-Nielsen
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  2. Max Rohde
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  3. Christian Godballe
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  4. Jesper G. Eriksen
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  7. Nina Nguyen
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Correspondence to Marie Westergaard-Nielsen.

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The authors have no conflicts of interest to declare. The research has been supported as PhD thesis by University of Southern Denmark.

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Westergaard-Nielsen, M., Rohde, M., Godballe, C. et al. Up-front F18-FDG PET/CT in suspected salivary gland carcinoma. Ann Nucl Med 33, 554–563 (2019). https://doi.org/10.1007/s12149-019-01362-9

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  • DOI: https://doi.org/10.1007/s12149-019-01362-9

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