Predictors of pathologic outcome of focal FDG uptake in the parotid gland identified on whole-body FDG PET imaging

Mabray, Marc C.; Behr, Spencer C.; Naeger, David M.; Flavell, Robert R.; Glastonbury, Christine M.

doi:10.1016/j.clinimag.2015.07.005

Cited by 11 publications

(9 citation statements)

References 25 publications

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“…Although certain imaging characteristics may allow for non-invasive characterization of parotid lesions, tissue sampling is often needed for accurate diagnosis. Few previous studies have reported pathologic findings of incidental parotid lesions detected on PET imaging [6][7][8]. However, the clinical significance of asymptomatic parotid lesions detected incidentally by other more frequently utilized imaging modalities remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological features of incidental parotid lesions

et al. 2021

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Background The purpose of this study is to determine the histopathological spectrum and risk of primary malignancy of asymptomatic parotid lesions incidentally discovered on cross-sectional imaging. Methods Over a 10-year period, 154 patients underwent 163 ultrasound-guided parotid lesion biopsies at our institution. This retrospective chart review included 89 lesions in 87 patients with asymptomatic parotid lesions discovered on cross-sectional imaging studies performed for unrelated clinical indications. The histopathologic findings of all sampled lesions were reviewed. We evaluated the patient demographics and pathological diagnoses of sampled parotid lesions to determine the histopathological spectrum and risk of malignancy. Results The average age was 67.5 years and 92 % were males. 25 % of patients had bilateral lesions. The average size of the parotid lesions was 1.5 cm and 91 % were located in the superficial lobe. 92.1 % of lesions were benign with Warthin tumor being the most common diagnosis followed by pleomorphic adenoma. 2.3 % of lesions were primary parotid malignant neoplasms, while 5.6 % were metastatic lesions in patients with known malignancy. Conclusions The incidence of primary parotid malignant neoplasm in asymptomatic incidentally discovered parotid lesions is low. Imaging or clinical follow-up may be considered in patients with incidental parotid lesions who prefer to avoid biopsy.

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Section: Introductionmentioning

confidence: 99%

Clinicopathological features of incidental parotid lesions

et al. 2021

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“…Only 4 % of focal parotid incidental uptake (FPIU) turned out to be malignant in the study group of Makis et al [24] and 9.6% in the metaanalysis of Treglia et al [26]. However, Ustun et al [25] reported an incidence of parotid metastases amounting to 36.4% and similarly high values of 45% were reported by Mabray et al [27], where FPIU was frequently a manifestation of the patient's known malignancy (metastasis or lymphoma). It has to be noted that the high malignancy rates in incidental masses detected on multimodal PET imaging are mostly due to the fact that PET/CTs are performed mostly in oncologic patients, with high probability of metastases.…”

Section: Chances Of Detecting Sismentioning

confidence: 85%

“…Clinical significance of SIs depends on the method of their detection. The most significant lesions seem to be tumors detected on multimodal PET imaging showing FDG uptake but these examinations were typically performed in patients with a known malignancy for staging [27]. SIs detected by other imaging modalities are most likely benign primary neoplasms or pseudotumors, including intraparenchymal lymph nodes.…”

Section: Clinical Significancementioning

confidence: 99%

WFUMB position paper. Incidental findings of the salivary glands

Białek¹,

Lim

Dong

et al. 2021

Med Ultrason

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A salivary incidentaloma (SI) stands for any focal salivary lesion, independent of size, discovered by any imaging method including ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), multimodal positron emis-sion tomography (PET) combined with CT or MRI, or X-ray imaging, performed for another reason, in the absence of known salivary glands’ disease. The article presents a detailed analysis of salivary gland diseases with the emphasis on neoplasms. It describes frequency of SIs found on imaging, their prevalence, epidemiology and clinical significance. The probability of malignancy or malignant transformation of a SI, its imaging features, recommended treatment, management and follow-up, as well as ethical issues, psychological burden, informed decision making, economical consequences and costs are discussed. The general prevalence of SIs is low, but is dramatically increasing over time, and may rise significantly in selected groups of oncologic patients. SIs most frequently turn out to be benign primary neoplasms or pseudotumors, including intraparenchymal lymph nodes. SIs detected by other imaging methods should be subsequently assessed with US. Solid SIs demand ultrasound guided fine-needle aspiration cytology (US-FNAC). Neoplasms should undergo surgery. Post-operative US follow-up is man-datory for malignant tumors and recommended for benign neoplasms.

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“…Focus is much more likely to be either a metastasis from the known cancer or benign. 14 Further evaluation may well be unnecessary No follow up required CT nodules demonstrating increased FDG uptake have a higher risk of malignancy 37 Refer to lung MDT/lung cancer specialist or follow up with CT depending on the risk of malignancy Oesophagus and GOJ Foci with the following characteristics are associated with malignancy: increased focality, eccentricity 43 and increased intensity of uptake (SUVmax > 6) 42 Routinely refer foci with these characteristics for endoscopy a Limitations in SUV reproducibility and individual patient characteristics, particularly other life-limiting comorbidities and patient choice, should be taken into account when using this evidence. FDG, fluorodeoxyglucose; GOJ, gastro-oesophageal junction; MDT, multidisciplinary team; SUV, standardized uptake value.…”

Section: Parotid: Patients Without Cancermentioning

confidence: 99%

Evidence-based management of incidental focal uptake of fluorodeoxyglucose on PET-CT

Pencharz

Nathan

Wagner

2018

The British Journal of Radiology

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Focal incidental uptake, with or without CT abnormalities, is a common finding on fluorodeoxyglucose PET/CT and evidence-based management for this type of uptake is lacking. This article reviews the evidence on focal incidental uptake including the incidence of malignancy, differential diagnosis and imaging criteria which can be used to further characterize it. The article focusses on PET rather than CT criteria. The strength of the evidence base is highly variable ranging from systematic reviews and meta-analyses to a virtual absence of evidence. Caution needs to be used when using standardized uptake values (SUVs) reported in other studies due to interpatient and institution observed variation in SUVs. There is sufficient evidence to permit specific suggestions on how to interpret the foci and recommend further management in the: pituitary (investigate when SUVmax >4.1), thyroid (investigate all), breast (investigate all), lung parenchyma (if focus of fluorodeoxyglucose without a CT nodule, no further investigations), colon (investigate all foci with SUVmax >5.9, urgently if SUVmax >11.4), adrenals (criteria depend on if patient has cancer) and prostate gland (investigate in males aged >50 years or >40 years if peripheral uptake or patient has other risk factors). There is some evidence to guide further management for the parotid gland, naso-orophaynx, oesophagus, pancreas, uterus and ovaries. There is insufficient evidence to guide management for the liver, spleen, kidneys, gallbladder, testis and bone, for these organs patient characteristics and other guidelines will likely be of more use in determining further management.

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Predictors of pathologic outcome of focal FDG uptake in the parotid gland identified on whole-body FDG PET imaging

Cited by 11 publications

References 25 publications

Clinicopathological features of incidental parotid lesions

Clinicopathological features of incidental parotid lesions

WFUMB position paper. Incidental findings of the salivary glands

Evidence-based management of incidental focal uptake of fluorodeoxyglucose on PET-CT

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