Positron Emission Tomography-Computed Tomography Adds to the Management of Salivary Gland Malignancies

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 scan: ning 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