Journal of Cancer Research and Clinical Oncology

, Volume 144, Issue 12, pp 2485–2493 | Cite as

Pre-treatment metabolic tumor volume predicts tumor metastasis and progression in high-grade salivary gland carcinoma

  • Turki M. Almuhaimid
  • Won Sub Lim
  • Jong-Lyel RohEmail author
  • Jungsu S. Oh
  • Jae Seung Kim
  • Soo-Jong Kim
  • Seung-Ho Choi
  • Soon Yuhl Nam
  • Sang Yoon Kim
Original Article – Clinical Oncology



High-grade salivary gland carcinoma (SGC) shows a high rate of metastasis and post-treatment recurrence, resulting in poor patient survival. Therefore, we evaluated the utility of pre-treatment 18F-FDG PET/CT parameters in predicting metastasis, tumor progression, and survival of high-grade SGC patients.


This observational study included 75 patients with previously untreated high-grade SGC who underwent pre-treatment 18F-FDG PET/CT scanning and subsequent treatment. Standardized uptake values (SUV), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured on pre-treatment 18F-FDG PET/CT. Logistic regression analysis was used to identify the relationship of these factors with metastasis. Cox proportional hazard regression analyses were used to identify associations between PET parameters and both progression-free survival (PFS) and overall survival (OS).


A total of 36 (48%) patients had neck or distant metastases at initial staging. After controlling for clinical factors, MTV (> 8.8 mL) was an independent factor for initial metastasis (adjusted odds ratio 4.80, 95% confidence interval 1.09–21.20; P = 0.039). All PET parameters of SUVmax (> 4.3), SUVmean (> 3.0), SUVpeak (3.9), MTV (> 8.8 mL), and TLG (> 31.1 g) were significant variables for PFS (all P < 0.05), while MTV and TLG were significant factors for OS. After controlling for clinicopathological factors, MTV (adjusted hazard ratio 4.36, 95% confidence interval 1.69–11.26; P = 0.002) and TLG (3.41, 1.47–7.91; P = 0.004) were significantly associated with PFS, but not OS.


MTV is useful among quantitative PET measurements for predicting initial metastasis and PFS in patients with high-grade SGC.


High-grade salivary gland cancer Metastasis 18F-FDG PET/CT Metabolic tumor volume Risk factors 



This study was supported by a Grant (no. 2015R1A2A1A15054540) from Basic Science Research Program through the National Research Foundation of Korea (NRF), Ministry of Science and ICT, Seoul, Republic of Korea (J.L. Roh).

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research board and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors. Informed consent from all individual participants was waved because of the retrospective nature of this study.

Supplementary material

432_2018_2760_MOESM1_ESM.tif (3.9 mb)
Supplementary Figure S1. Measurement of standardized uptake value (SUV) and metabolic tumor volume (MTV). The region of interest (circled) was set to include high grade salivary gland carcinoma (SGC) with metabolic activity, and software automatically calculated the SUVmax, SUVmean, SUVpeak and MTV. Total lesion glycolysis (TLG) was calculated as MTV × SUVmean. A 52-year old male patient (A) died of disease at 21 months after chemoradiotherapy for T4N2M1 salivary duct carcinoma, whereas 50-year old male patient (B) has been disease-free for 134 months since surgery plus radiotherapy for T2N0M0 high-grade carcinoma ex pleomorphic adenoma in the parotid gland. (TIF 3996 KB)
432_2018_2760_MOESM2_ESM.docx (19 kb)
Supplementary material 2 (DOCX 19 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Otolaryngology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
  2. 2.Department of Nuclear Medicine, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
  3. 3.Department of SurgeryKing Fahad Specialist HospitalDammamSaudi Arabia

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