Article Figures & Data
Figures
- FIGURE 1.
Imaging findings of 65-y-old man with slow-growing mass in left preauricular area. (A) CT image showing no enhancing lesion in left parotid gland. (B and C) 18F-FDG PET image showing focal 18F-FDG uptake by left parotid gland (SUVmax = 2.2) and by left side neck level II (SUVmax = 3.0). Final pathology showed salivary duct carcinoma of parotid gland and level II neck node.
- FIGURE 2.
(A) Transaxial 18F-FDG PET image of 62-y-old man with SDC of right parotid gland, showing focal 18F-FDG uptake by right neck level V. (B) CT image showing no significant lymph nodes at same neck level. On basis of results of 18F-FDG PET, type of neck dissection was changed from supraomohyoid to modified or radical. Pathology showed metastatic carcinomas of neck levels I to V.
Tables
Characteristic No. Median Range Percentage Sex Male 14 77.8 Female 4 22.2 Age (y) 58 39–73 Location Parotid/submandibular/sublingual pathologic TNM stage (16) 11/6/1 61.1/33.3/5.6 T classification T1/T2/T3/T4 3/7/5/3 16.7/38.9/27.8/16.6 N classification N0/N1–2 1/17 5.6/94.4 M classification M0/M1 18/0 100/0 Pathologic findings Size of primary tumor (cm) 2.5 1.3–9 Lymphovascular invasion 11 61.1 Perineural invasion 7 38.9 Extraparenchymal invasion 11 61.1 Resection margin (positive, close) 11 61.1 Initial treatment Surgery + radiotherapy 15 83.3 Surgery + radiotherapy + CT 3 16.7 Neck dissection Yes 16 88.9 No 2 11.1 Treatment outcome No evidence of disease 11 61.1 Alive with disease 1 5.6 Die of disease 6 33.3 Follow-up period (mo) 16 4–94 Primary lesions Patient no. Age (y) Sex Tumor site PET CT FNAB Primary SUVs Neck node SUVs Tumor size Metastasis Status 1 67 M PRT + + H-G ca 1.8 NU 2.5 NED 2 57 F SL + + L-G ca 4.7 5.9 9 T, N, M DOD 3 46 F PRT + + Metastatic carcinoma 8 8 2.5 NED 4 40 M PRT + + H-G ca 4.9 5.2 2.3 N, M DOD 5 62 M PRT + + Carcinoma 3.5 1.7 4.8 NED 6 64 M PRT + + H-G ca 8.3 1.7 4 NED 7 66 M SMG + + Carcinoma 4.6 6.8 1.7 M DOD 8 49 M PRT + + H-G ca 4 2 6 NED 9 56 M PRT + + H-G ca 5.7 NU 2 NED 10 73 M SMG + + SDC 12.1 NU 1.5 NED 11 60 F SMG + + SDC 10.7 13 3.7 N, M DOD 12 50 M SMG + + SDC 7.2 7.2 5.5 NED 13 65 M PRT + - L-C ca 2.2 3 1.3 M DOD 14 64 M PRT + + H-G ca 2 2 3.1 M DOD 15 72 M SMG + + MEC 3.2 5 2.7 T, N, M AWD 16 69 F PRT + + NSC 4.3 8.6 2.2 NED 17 47 M SMG + + H-G ca 4.7 5.8 1.8 NED 18 39 M PRT + + H-G ca 11.8 10 2.7 NED PRT = parotid gland; H-G ca = high-grade carcinoma; NU = no uptake; NED = no evidence of disease; SL = sublingual gland; L-G ca = low-grade carcinoma; DOD = die of disease; SMG = submandibular gland; SDC = salivary duct carcinoma; L-C ca = large cell carcinoma; MEC = mucoepidermoid carcinoma; AWD = alive with disease; NSC = non–small cell carcinoma.
SUV Tumor F-FDG uptake Median Range Primary tumor 4.7 1.8–12 Parotid gland (n = 11) 4.3 1.8–12 Submandibular gland (n = 7) 4.7 3–12 Sublingual gland (n = 1) 5.9 Lymph nodes 5.8 CT PET/CT Parameter True-positive False-positive False-negative True-negative True-positive False-positive False-negative True-negative Neck node level I 5 0 5 6 7 0 3 6 II 9 1 4 2 13 1 0 2 III 3 1 7 5 7 0 3 6 IV 1 0 5 6 2 0 4 6 V 0 0 6 6 5 0 1 6 Contralateral neck 1 1 0 Total 18 2 28 25 35 1 11 26 - TABLE 5
Sensitivity, Specificity, and Predictive Values for PET and CT for Neck Dissection
CT PET/CT Parameter Percentage 95% confidence interval Percentage 95% confidence interval P Sensitivity 39.1 25.1–54.6 76.1 61.2–87.4 <0.001 Specificity 92.6 75.7–99.1 96.3 81.0–99.9 Not significant Positive prognostic value 90.0 68.3–98.9 97.2 85.9–99.9 Not significant Negative prognostic value 47.2 33.3–61.4 70.3 53.0–84.1 0.03
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