Can Dual-Time-Point <sup>18</sup>F-FDG PET/CT Differentiate Malignant Salivary Gland Tumors From Benign Tumors?

OBJECTIVE Assessment of benign and malignant lesions of the parotid gland, including metastatic lesions, is challenging with current imaging methods. Fluorine-18 FDG PET/CT is a noninvasive imaging modality that provides both anatomic and metabolic information. Semiquantitative data obtained from PET/CT, also known as PET/CT parameters, are maximum, mean, or peak standardized uptake values (SUVs); metabolic tumor volume; total lesion glycolysis; standardized added metabolic activity; and normalized standardized added metabolic activity. Our aim was to determine whether FDG PET/CT parameters can differentiate benign, malignant, and metastatic parotid tumors. MATERIALS AND METHODS Thirty-four patients with parotid neoplasms underwent PET/CT before parotidectomy; maximum SUV, mean SUV, peak SUV, total lesion glycolysis, metabolic tumor volume, standardized added metabolic activity, and normalized standardized added metabolic activity were calculated on a dedicated workstation. Univariate analyses were performed. A ROC analysis was used to determine the ability of PET/CT parameters to predict pathologically proven benign, malignant, and metastatic parotid gland neoplasms. RESULTS Fourteen patients had a benign or malignant primary parotid tumor. Twenty had metastases to the parotid gland. When the specificity was set to at least 85% for each parameter to identify cut points, the corresponding sensitivities ranged from 15% to 40%. Assessment of benign versus malignant lesions of parotid tumors, as well as metastasis from squamous cell carcinoma versus other metastatic causes, revealed that none of the PET/CT parameters has enough power to differentiate among these groups. CONCLUSION PET/CT parameters, including total lesion glycolysis, metabolic tumor volume, standardized added metabolic activity, and normalized standardized added metabolic activity, are not able to differentiate benign from malignant parotid tumors, primary parotid tumors from metastasis, or metastasis from squamous cell carcinoma and nonsquamous cell carcinoma metastasis.

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“…Toriihara et al [18] found that dual-time-point FDG PET/CT was not useful for discriminating benign versus malignant salivary gland tumors.…”

Section: Discussionmentioning

confidence: 99%

Is There a Role for PET/CT Parameters to Characterize Benign, Malignant, and Metastatic Parotid Tumors?

Kendi

Magliocca

Corey

et al. 2016

American Journal of Roentgenology

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“…An association of these findings with the sertoli cell tumor was considered very unlikely. Furthermore a human study concluded that a differentiation between benign and malignant salivary gland tumors is not possible by FDG PET/CT based on an increased FDG uptake [32]. Therefore, these findings were not included in further treatment decisions for the dog.…”

Section: Discussionmentioning

confidence: 99%

Comparative Oncology: Evaluation of 2-Deoxy-2-[18F]fluoro-D-glucose (FDG) Positron Emission Tomography/Computed Tomography (PET/CT) for the Staging of Dogs with Malignant Tumors

et al. 2015

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Introduction2-Deoxy-2-[18F]fluoro-D-glucose PET/CT is a well-established imaging method for staging, restaging and therapy-control in human medicine. In veterinary medicine, this imaging method could prove to be an attractive and innovative alternative to conventional imaging in order to improve staging and restaging. The aim of this study was both to evaluate the effectiveness of this image-guided method in canine patients with spontaneously occurring cancer as well as to illustrate the dog as a well-suited animal model for comparative oncology.MethodsTen dogs with various malignant tumors were included in the study and underwent a whole body FDG PET/CT. One patient has a second PET-CT 5 months after the first study. Patients were diagnosed with histiocytic sarcoma (n = 1), malignant lymphoma (n = 2), mammary carcinoma (n = 4), sertoli cell tumor (n = 1), gastrointestinal stromal tumor (GIST) (n = 1) and lung tumor (n = 1). PET/CT data were analyzed with the help of a 5-point scale in consideration of the patients’ medical histories.ResultsIn seven of the ten dogs, the treatment protocol and prognosis were significantly changed due to the results of FDG PET/CT. In the patients with lymphoma (n = 2) tumor extent could be defined on PET/CT because of increased FDG uptake in multiple lymph nodes. This led to the recommendation for a therapeutic polychemotherapy as a treatment. In one of the dogs with mammary carcinoma (n = 4) and in the patient with the lung tumor (n = 1), surgery was cancelled due to the discovery of multiple metastasis. Consequently no treatment was recommended.ConclusionFDG PET/CT offers additional information in canine patients with malignant disease with a potential improvement of staging and restaging. The encouraging data of this clinical study highlights the possibility to further improve innovative diagnostic and staging methods with regard to comparative oncology. In the future, performing PET/CT not only for staging but also in therapy control could offer a significant improvement in the management of dogs with malignant tumors.

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“…In a third study on 26 esophageal cancer patients specificity to detect metastatic lesions was improved when retention index (RI) 10% was used to supplement the early SUVmax of ≥ 2.5 (32) . On the other hand there are other studies that reported no improvement in diagnostic accuracy by the use of delayed imaging (33)(34)(35)(36) . In most of these studies the delayed SUVmax or RI were used separately versus the early SUVmax and not in conjunction with the early SUVmax.…”

Section: Discussionmentioning

confidence: 94%

Diagnostic Accuracy of 18F-FDG PET/CT in Detection of Local Recurrence in Rectal Cancer and the Added Value of Dual Time Point Scanning

Farghaly

2013

The Egyptian Journal Nuclear Medicine

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Can Dual-Time-Point ¹⁸F-FDG PET/CT Differentiate Malignant Salivary Gland Tumors From Benign Tumors?

Abstract: Dual-time-point FDG PET/CT is not useful for discriminating between benign and malignant salivary gland tumors, because benign tumors also show high FDG uptake, which increases in the delayed phase.

Cited by 28 publications

References 12 publications

Is There a Role for PET/CT Parameters to Characterize Benign, Malignant, and Metastatic Parotid Tumors?

Is There a Role for PET/CT Parameters to Characterize Benign, Malignant, and Metastatic Parotid Tumors?

Comparative Oncology: Evaluation of 2-Deoxy-2-[18F]fluoro-D-glucose (FDG) Positron Emission Tomography/Computed Tomography (PET/CT) for the Staging of Dogs with Malignant Tumors

Diagnostic Accuracy of 18F-FDG PET/CT in Detection of Local Recurrence in Rectal Cancer and the Added Value of Dual Time Point Scanning

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Can Dual-Time-Point 18F-FDG PET/CT Differentiate Malignant Salivary Gland Tumors From Benign Tumors?

Abstract: Dual-time-point FDG PET/CT is not useful for discriminating between benign and malignant salivary gland tumors, because benign tumors also show high FDG uptake, which increases in the delayed phase.

Cited by 28 publications

References 12 publications

Is There a Role for PET/CT Parameters to Characterize Benign, Malignant, and Metastatic Parotid Tumors?

Is There a Role for PET/CT Parameters to Characterize Benign, Malignant, and Metastatic Parotid Tumors?

Comparative Oncology: Evaluation of 2-Deoxy-2-[18F]fluoro-D-glucose (FDG) Positron Emission Tomography/Computed Tomography (PET/CT) for the Staging of Dogs with Malignant Tumors

Diagnostic Accuracy of 18F-FDG PET/CT in Detection of Local Recurrence in Rectal Cancer and the Added Value of Dual Time Point Scanning

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Can Dual-Time-Point ¹⁸F-FDG PET/CT Differentiate Malignant Salivary Gland Tumors From Benign Tumors?