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

Authors

  • Ali Razfar BS,

    1. Department of Otolaryngology/Head and Neck Surgery , University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
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  • Dwight E. Heron MD,

    1. Department of Radiation Oncology , Pittsburgh, Pennsylvania, U.S.A.
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  • Barton F. Branstetter IV MD,

    1. Department of Otolaryngology/Head and Neck Surgery , University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
    2. Department of Radiology , Pittsburgh, Pennsylvania, U.S.A.
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  • Raja R. Seethala MD,

    1. Department of Otolaryngology/Head and Neck Surgery , University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
    2. Department of Pathology and Laboratory Medicine , University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A.
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  • Robert L. Ferris MD, PhD

    Corresponding author
    1. Department of Otolaryngology/Head and Neck Surgery , University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
    2. University of Pittsburgh Cancer Institute , Pittsburgh, Pennsylvania, U.S.A.
    • University of Pittsburgh Cancer Institute, 200 Lothrop Street, Pittsburgh, PA 15213
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  • Presented at the 2009 Annual Meeting of the American Academy of Otolaryngology–Head and Neck Surgery, San Diego, California, U.S.A, October 4–7, 2009.

  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

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

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