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Clinical Utility of ¹⁸F-FDG PET for Patients with Salivary Gland Malignancies

¹ Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; ² Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; ³ Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; and ⁴ Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

Correspondence: For correspondence contact: Jong-Lyel Roh, MD, PhD, Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap-dong, Songpa-gu, Seoul 138-736, South Korea. E-mail: rohjl{at}amc.seoul.kr

The clinical utility of ¹⁸F-FDG PET in evaluating salivary gland malignancies has not been well defined. We therefore evaluated the utility of ¹⁸F-FDG PET in management for patients with salivary gland cancers. Methods: Thirty-four patients with newly diagnosed salivary gland cancers underwent CT and ¹⁸F-FDG PET before surgical resection with radiotherapy. The diagnostic accuracies of CT and ¹⁸F-FDG PET for detecting primary tumors and neck metastases were compared with a histopathologic reference. We determined the relationship between the maximum standardized uptake value (SUV) of the tumor and clinicopathologic parameters such as sex, age, local tumor invasion, T and N categories, TNM stage, and histologic grade, as well as their associations with disease-free survival (DFS). Results: ¹⁸F-FDG PET was more sensitive than CT for the detection of primary tumors (91.2% vs. 79.4%; P < 0.05), cervical metastases (80.5% vs. 56.1%; P < 0.05), and distant metastases in 2 patients at initial staging. High-grade malignancies had higher mean maximum SUVs than did low- and intermediate-grade malignancies (4.6 vs. 2.8; P = 0.011). T and N categories were independent determinants of DFS (P < 0.05), but the maximum SUV (4.0) was not. During a mean follow-up of 25.1 mo, ¹⁸F-FDG PET correctly diagnosed local–regional recurrences in 6 patients and new distant metastases in 9 patients. Conclusion: Our findings indicate that, in patients with salivary gland malignancies, ¹⁸F-FDG PET is clinically useful in initial staging, histologic grading, and monitoring after treatment but not in predicting patient survival.

Key Words: salivary gland cancer • ¹⁸F-FDG PET • staging • histologic grading • predictive factor • standardized uptake value

COPYRIGHT © 2007 by the Society of Nuclear Medicine, Inc.

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