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

  • Marie Westergaard-NielsenEmail author
  • Max Rohde
  • Christian Godballe
  • Jesper G. Eriksen
  • Stine Rosenkilde Larsen
  • Oke Gerke
  • Nina Nguyen
  • Mie K. Nielsen
  • Anne L. Nielsen
  • Anders Thomassen
  • Jon T. Asmussen
  • Anabel Diaz
  • Poul Flemming Høilund-Carlsen
  • Kristine Bjørndal
Original Article
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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.

Keywords

Salivary gland carcinoma Salivary gland tumours PET/CT Diagnostic imaging Staging 

Notes

Compliance with ethical standards

Conflict of interest

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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Copyright information

© The Japanese Society of Nuclear Medicine 2019

Authors and Affiliations

  • Marie Westergaard-Nielsen
    • 1
    Email author
  • Max Rohde
    • 1
  • Christian Godballe
    • 1
  • Jesper G. Eriksen
    • 3
  • Stine Rosenkilde Larsen
    • 2
  • Oke Gerke
    • 5
  • Nina Nguyen
    • 4
  • Mie K. Nielsen
    • 4
  • Anne L. Nielsen
    • 5
  • Anders Thomassen
    • 5
  • Jon T. Asmussen
    • 4
  • Anabel Diaz
    • 4
  • Poul Flemming Høilund-Carlsen
    • 5
  • Kristine Bjørndal
    • 1
  1. 1.Department of ORL-Head and Neck Surgery and AudiologyOdense University HospitalOdense CDenmark
  2. 2.Department of PathologyOdense University HospitalOdenseDenmark
  3. 3.Department of Experimental Clinical OncologyAarhus University HospitalAarhusDenmark
  4. 4.Department of RadiologyOdense University HospitalOdenseDenmark
  5. 5.Department of Nuclear MedicineOdense University HospitalOdenseDenmark

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