Skip to main content
SpringerLink
Log in

The Role of Imaging in Staging and Follow-Up of Salivary Gland Tumors

  • Chapter
  • First Online:
Salivary Gland Cancer

  • 585 Accesses

Abstract

The role of imaging in salivary gland neoplasms is to detect the tumor and possibly classify it as benign or malignant. In malignant tumor, imaging helps to stage the lesion according to the TNM classification, defining the size, the extension of the tumor, the involvement of the adjacent structures and detecting local or distant metastases. Imaging is also essential to guide biopsies, to plan therapy and to evaluate response to treatment. Imaging plays an important role during follow-up as it allows for early detection of recurrence; this role is crucial for those relapses that can be still treated, in the attempt to modify patients’ prognosis. For superficial tumors, especially within the parotid and the submandibular glands, ultrasound is the modality of choice for initial workup. If extra-glandular tumor extension is suspected, advanced techniques such as computed tomography or magnetic resonance imaging should be carried out. On the other side, for salivary gland tumors arising from the upper aerodigestive tract, endoscopy and CT examination are essentials. Positron emission tomography-computed tomography with fluorine-18-deoxy-d-glucose (FDG PET-CT) is not routinely recommended for the diagnosis and initial staging of salivary gland tumors, especially in histotypes with low glucose avidity. However, FDG PET-TC may be useful for detecting cervical lymph node and distant metastases.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

ACC:

Adenoid cystic carcinoma

ADC:

Apparent diffusion coefficient

CNB:

Core needle biopsy

CT:

Computed tomography

DCE-MRI:

Dynamic contrast-enhanced Magnetic Resonance Imaging

DWI:

Diffusion-weighted imaging

FDG PET-CT:

Positron emission tomography-computed tomography with fluorine-18-deoxy-d-glucose

FNAC:

Fine needle aspiration cytology

FS:

Fat saturation

GE:

Gradient echo

MET:

11C-methionine

MRI:

Magnetic resonance imaging

NOS:

Not otherwise specified

SGTs:

Salivary gland tumor

SUV:

Standardized uptake value

T1W:

T1-weighted

T2W:

T2-weighted

T-peak:

Time-to-peak enhancement

US:

Ultrasound

WR:

Washout ratio

References

  1. Freling N, Crippa F, Maroldi R. Staging and follow-up of high-grade malignant salivary gland tumours: the role of traditional versus functional imaging approaches - a review. Oral Oncol. 2016;60:157–66. https://doi.org/10.1016/j.oraloncology.2016.04.016. Epub 2016 May 25.

    Article  PubMed  Google Scholar 

  2. Lee YY, Wong KT, King AD, Ahuja AT. Imaging of salivary gland tumours. Eur J Radiol. 2008;66(3):419–36. https://doi.org/10.1016/j.ejrad.2008.01.027. Epub 2008 Mar 11.

    Article  CAS  PubMed  Google Scholar 

  3. Wyszyńska-Pawelec G, Gontarz M, Zapała J, Szuta M. Minor salivary gland tumours of upper aerodigestive tract: a clinicopathological study. Gastroenterol Res Pract. 2012;2012:780453. https://doi.org/10.1155/2012/780453. Epub 2012 May 21.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Guzzo M, Locati LD, Prott FJ, Gatta G, McGurk M, Licitra L. Major and minor salivary gland tumors. Crit Rev Oncol Hematol. 2010;74(2):134–48. https://doi.org/10.1016/j.critrevonc.2009.10.004. Epub 2009 Nov 24.

    Article  PubMed  Google Scholar 

  5. Thoeny HC. Imaging of salivary gland tumours. Cancer Imaging. 2007;7:52–62.

    Article  Google Scholar 

  6. Bialek EJ, Jakubowski W, Zajkowski P, Szopinski KT, Osmolski A. US of the major salivary glands: anatomy and spatial relationships, pathologic conditions, and pitfalls. Radiographics. 2006;26(3):745–63.

    Article  Google Scholar 

  7. Ying M, Ahuja A. Sonography of neck lymph nodes. Part I: normal lymph nodes. Clin Radiol. 2003;58(5):351–8.

    Article  CAS  Google Scholar 

  8. Shimizu M, Ussmüller J, Hartwein J, Donath K, Kinukawa N. Statistical study for sonographic differential diagnosis of tumorous lesions in the parotid gland. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88(2):226–33.

    Article  CAS  Google Scholar 

  9. Kim J, Kim EK, Park CS, Choi YS, Kim YH, Choi EC. Characteristic sonographic findings of Warthin’s tumor in the parotid gland. J Clin Ultrasound. 2004;32(2):78–81.

    Article  Google Scholar 

  10. Zajkowski P, Jakubowski W, Białek EJ, Wysocki M, Osmólski A, Serafin-Król M. Pleomorphic adenoma and adenolymphoma in ultrasonography. Eur J Ultrasound. 2000;12(1):23–9.

    Article  CAS  Google Scholar 

  11. Schick S, Steiner E, Gahleitner A, Böhm P, Helbich T, Ba-Ssalamah A, Mostbeck G. Differentiation of benign and malignant tumors of the parotid gland: value of pulsed Doppler and color Doppler sonography. Eur Radiol. 1998;8(8):1462–7.

    Article  CAS  Google Scholar 

  12. Dequanter D, Lothaire P, Andry G. Secondary malignant tumors of the parotid. Ann Otolaryngol Chir Cervicofac. 2005;122(1):18–20.

    Article  CAS  Google Scholar 

  13. Bozzato A, Zenk J, Greess H, Hornung J, Gottwald F, Rabe C, Iro H. Potential of ultrasound diagnosis for parotid tumors: analysis of qualitative and quantitative parameters. Otolaryngol Head Neck Surg. 2007;137(4):642–6.

    Article  Google Scholar 

  14. Wong DS, Li GK. The role of fine-needle aspiration cytology in the management of parotid tumors: a critical clinical appraisal. Head Neck. 2000;22(5):469–73.

    Article  CAS  Google Scholar 

  15. Novoa E, Gürtler N, Arnoux A, Kraft M. Role of ultrasound-guided core-needle biopsy in the assessment of head and neck lesions: a meta-analysis and systematic review of the literature. Head Neck. 2012;34(10):1497–503. https://doi.org/10.1002/hed.21821. Epub 2011 Aug 24.

    Article  PubMed  Google Scholar 

  16. Wan YL, Chan SC, Chen YL, Cheung YC, Lui KW, Wong HF, Hsueh C, See LC. Ultrasonography-guided core-needle biopsy of parotid gland masses. AJNR Am J Neuroradiol. 2004;25(9):1608–12.

    PubMed  Google Scholar 

  17. Christe A, Waldherr C, Hallett R, Zbaeren P, Thoeny H. MR imaging of parotid tumors: typical lesion characteristics in MR imaging improve discrimination between benign and malignant disease. AJNR Am J Neuroradiol. 2011;32(7):1202–7. https://doi.org/10.3174/ajnr.A2520. Epub 2011 Jun 30.

    Article  CAS  PubMed  Google Scholar 

  18. Yousem DM, Kraut MA, Chalian AA. Major salivary gland imaging. Radiology. 2000;216(1):19–29.

    Article  CAS  Google Scholar 

  19. Habermann CR, Arndt C, Graessner J, Diestel L, Petersen KU, Reitmeier F, Ussmueller JO, Adam G, Jaehne M. Diffusion-weighted echo-planar MR imaging of primary parotid gland tumors: is a prediction of different histologic subtypes possible? AJNR Am J Neuroradiol. 2009;30(3):591–6. https://doi.org/10.3174/ajnr.A1412. Epub 2009 Jan 8.

    Article  CAS  PubMed  Google Scholar 

  20. Thoeny HC, De Keyzer F, Boesch C, Hermans R. Diffusion-weighted imaging of the parotid gland: influence of the choice of b-values on the apparent diffusion coefficient value. J Magn Reson Imaging. 2004;20(5):786–90.

    Article  Google Scholar 

  21. Yabuuchi H, Fukuya T, Tajima T, Hachitanda Y, Tomita K, Koga M. Salivary gland tumors: diagnostic value of gadolinium-enhanced dynamic MR imaging with histopathologic correlation. Radiology. 2003;226(2):345–54.

    Article  Google Scholar 

  22. Assili S, Fathi Kazerooni A, Aghaghazvini L, Saligheh Rad HR, Pirayesh Islamian J. Dynamic contrast magnetic resonance imaging (DCE-MRI) and diffusion weighted MR imaging (DWI) for differentiation between benign and malignant salivary gland tumors. J Biomed Phys Eng. 2015;5(4):157–68. eCollection 2015 Dec.

    CAS  PubMed  PubMed Central  Google Scholar 

  23. Shimamoto H, Chindasombatjaroen J, Kakimoto N, Kishino M, Murakami S, Furukawa S. Perineural spread of adenoid cystic carcinoma in the oral and maxillofacial regions: evaluation with contrast-enhanced CT and MRI. Dentomaxillofac Radiol. 2012;41(2):143–51. https://doi.org/10.1259/dmfr/21825064.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Gillespie MB, Albergotti WG, Eisele DW. Recurrent salivary gland cancer. Curr Treat Options in Oncol. 2012;13(1):58–70. https://doi.org/10.1007/s11864-011-0174-0.

    Article  Google Scholar 

  25. Terhaard CH, Lubsen H, Van der Tweel I, Hilgers FJ, Eijkenboom WM, Marres HA, Tjho-Heslinga RE, de Jong JM, Roodenburg JL, Dutch Head and Neck Oncology Cooperative Group. Salivary gland carcinoma: independent prognostic factors for locoregional control, distant metastases, and overall survival: results of the Dutch head and neck oncology cooperative group. Head Neck. 2004;26(8):681–92; discussion 692-3.

    Article  Google Scholar 

  26. Thoeny HC, De Keyzer F, King AD. Diffusion-weighted MR imaging in the head and neck. Radiology. 2012;263(1):19–32. https://doi.org/10.1148/radiol.11101821.

    Article  PubMed  Google Scholar 

  27. Sood S, McGurk M, Vaz F. Management of salivary gland tumours: United Kingdom national multidisciplinary guidelines. J Laryngol Otol. 2016;130(Suppl 2):S142–9. https://doi.org/10.1017/S0022215116000566.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Minn H, Clavo AC, Grénman R, Wahl RL. In vitro comparison of cell proliferation kinetics and uptake of tritiated fluorodeoxyglucose and L-methionine in squamous-cell carcinoma of the head and neck. J Nucl Med. 1995;36(2):252–8.

    CAS  PubMed  Google Scholar 

  29. Park SB, Choi JY, Lee EJ, Yoo J, Cheon M, Cho SK, Choe YS, Lee KH, Kim BT. Diagnostic criteria on (18)F-FDG PET/CT for differentiating benign from malignant focal hypermetabolic lesions of parotid gland. Nucl Med Mol Imaging. 2012;46(2):95–101.

    Article  Google Scholar 

  30. Toriihara A, Nakamura S, Kubota K, Makino T, Okochi K, Shibuya H. Can dual-time-point 18F-FDG PET/CT differentiate malignant salivary gland tumors from benign tumors? AJR Am J Roentgenol. 2013;201(3):639–44.

    Article  Google Scholar 

  31. Jeong HS, Chung MK, Son YI, Choi JY, Kim HJ, Ko YH, Baek CH. Role of 18F-FDG PET/CT in management of high-grade salivary gland malignancies. J Nucl Med. 2007;48(8):1237–44.

    Article  Google Scholar 

  32. Razfar A, Heron DE, Branstetter BF 4th, Seethala RR, Ferris RL. Positron emission tomography-computed tomography adds to the management of salivary gland malignancies. Laryngoscope. 2010;120(4):734–8.

    Article  Google Scholar 

  33. Toubaru S, Yoshikawa K, Ohashi S, Tanimoto K, Hasegawa A, Kawaguchi K, Saga T, Kamada T. Accuracy of methionine-PET in predicting the efficacy of heavy particle therapy on primary adenoid cystic carcinomas of the head and neck. Radiat Oncol. 2013;8:143.

    Article  Google Scholar 

  34. Rasmussen JH, Nørgaard M, Hansen AE, Vogelius IR, Aznar MC, Johannesen HH, Costa J, Engberg AM, Kjær A, Specht L, Fischer BM. Feasibility of multiparametric imaging with PET/MR in head and neck squamous cell carcinoma. J Nucl Med. 2017;58(1):69–74.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    Silvana Sdao, Enrico Civelli & Giuseppina Calareso

  2. Nuclear Medicine Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    Alessandra Alessi

Authors
  1. Silvana Sdao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Enrico Civelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alessandra Alessi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Giuseppina Calareso
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Silvana Sdao .

Editor information

Editors and Affiliations

  1. Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori Milan, Milan, Italy

    Lisa Licitra

  2. Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori Milan, Milan, Italy

    Laura D. Locati

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Sdao, S., Civelli, E., Alessi, A., Calareso, G. (2019). The Role of Imaging in Staging and Follow-Up of Salivary Gland Tumors. In: Licitra, L., Locati, L. (eds) Salivary Gland Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-02958-6_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-02958-6_3

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-02957-9

  • Online ISBN: 978-3-030-02958-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation