Positron emission tomography‐computed tomography adds to the management of salivary gland malignancies

Abstract

Objectives/Hypothesis: To evaluate the efficacy of combined positron emission tomography‐computed tomography (PET‐CT) in identifying salivary gland malignancies and to examine the role of PET‐CT in the management of these patients. Study Design: Retrospective chart review. Methods: Fifty‐five patients with diagnosed salivary gland cancer who had undergone PET‐CT scanning were retrospectively reviewed from January 2000 to October 2008. PET‐CT scans using intravenous contrast were correlated with clinicopathological information to determine diagnostic accuracy of disease extent. The impact of PET‐CT findings on therapeutic management was analyzed. All histopathologic grades were included in the study. Results: Overall, PET‐CT demonstrated a sensitivity of 74.4%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 61.5%. PET‐CT also identified unrecognized distant metastases in the following sites: six lung, five bone, two distant lymph nodes, and one liver. PET‐CT added to management in 26 patients (47.3%), and it was the deciding diagnostic modality in eight patients (14.5%). Of these 26 patients, 14 patients underwent additional surgery. Three patients with recurrence underwent PET‐CT scan‐directed radiation and/or chemotherapy, whereas nine patients diagnosed with distant disease received palliative treatment. Conclusions: PET‐CT is useful for planning the most appropriate treatment by identifying clinically unrecognized disease. PET‐CT shows a high diagnostic accuracy for detecting disease recurrence and distant metastases, thus helping to determine whether patients are candidates for potentially curative or palliative treatment. Laryngoscope, 2010