Retrospective review: Usefulness of a number of imaging modalities including CT, MRI, technetium-99m pertechnetate scintigraphy, gallium-67 scintigraphy and F-18-FDG PET in the differentiation of benign from malignant parotid masses

Abstract

An efficient combination of imaging methods may be helpful for achieve the correct diagnosis.

Differential diagnosis of Warthin’s tumor complicated with lung adenocarcinoma by 18F- FDG PET/CT imaging and radioisotope scanning with Tc-99m pertechnetate: A case report and literature review

“…Except the physiological concentration of 18F-FDG, benign lesions with increased FDG uptake are found in more than 25% of the PET/CT studies performed in patients with proven or suspected malignancy, with inflammation being the most common cause [11] . The high FDG uptake in some benign parotid gland tumors, particularly Warthin's tumor, was extensively observed and reported [9,[11][12][13][14] . This tumor may be found incidentally during FDG PET studies.…”

“…Considering the notable percentage (6%-24%) of Warthin's tumor in the parotid tumors [1,3,5,6] , the positive 18F-FDG PET/CT imaging of parotid glands, especially when asymmetrical and focal, should be interpreted cautiously with the characterization on the integrated CT and thought as a signal of radioisotope scanning with Tc-99m pertechnetate [9,12,14] and FNA.…”

“…The radioisotope scanning with Tc-99m pertechnetate of Warthin's tumor was positive and strongly recommended to be used to distinguish the Warthin's tumor from other parotid gland tumors [3,5,[8][9][10]12,14] . The technique is well established and involves imaging of the parotid gland in the posterior projection after the intravenous infusion of 5 mCi of the tracer at 60s intervals for 20 min and obtaining final images of the patient after hydration in right lateral and left lateral positions, followed by washout images obtained 3 min after stimulation with orally administered lemon juice or Vitamin C tablet to determine adequacy and symmetry of glandular secretion [3,5,[8][9][10] .…”

Epithelial–myoepithelial carcinoma of a minor salivary gland in the buccal mucosa

“…Recent (9200) Oral Radiol research has demonstrated the clinical usefulness of fluorodeoxyglucose-PET in diagnosing head and neck cancer, with a high sensitivity and specificity for detecting lesions comparable to CT and MRI examinations [8][9][10]. However, the diagnostic value of FDG for malignant salivary gland tumors has been found to be limited in cases of low specificity [9,10]. The finding of abnormal FDG accumulation in our case allowed for exclusion of a high-grade malignant tumor because systemic metastasis was not detected.…”

“…Preoperative diagnosis is sometimes difficult because the histological findings are similar to those of other salivary gland tumors. Use of diagnostic imaging modalities such as computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) combined with biopsy or fine needle aspiration cytology is, thus, helpful for a proper diagnosis [7][8][9].…”