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01.01.2015 | Head and Neck

Incidental focal FDG uptake in the parotid glands on PET/CT in patients with head and neck malignancy

verfasst von: Young Lan Seo, Dae Young Yoon, Sora Baek, Kyoung Ja Lim, Eun Joo Yun, Young Kwon Cho, Woo Jin Bae, Eun Jae Chung, Kee Hwan Kwon

Erschienen in: European Radiology | Ausgabe 1/2015

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Abstract

Objectives

To evaluate the prevalence and clinical significance of focal parotid lesions identified by ¹⁸ F- FDG PET/CT in patients with nonparotid head and neck malignancies.

Methods

From 3,638 PET/CT examinations using ¹⁸ F-FDG conducted on 1,342 patients with nonparotid head and neck malignancies, we retrospectively identified patients showing incidental focal FDG uptake in the parotid glands. The diagnosis of parotid lesions was confirmed histopathologically or on imaging follow-up. Patient demographics, clinical features, maximum standardized uptake value (SUV_max) on PET images, size and attenuation on corresponding contrast-enhanced CT images were assessed and correlated with the final diagnosis.

Results

The prevalence of incidental focal parotid FDG uptake on PET/CT was 2.1 % (95 % CI 1.4 – 3.0 %). Among 21 patients with focal parotid lesions confirmed histologically or on imaging follow-up, 7 (33.3 %) had malignant lesions (all metastases) and 14 (66.7 %) had benign lesions (four pleomorphic adenomas, two Warthin's tumours, one benign lymph node, one granulomatous lesion, six lesions without histopathological confirmation). There were no significant differences in age, sex, SUV_max or CT findings between patients with benign and those with malignant lesions.

Conclusion

Focal parotid FDG uptake on PET/CT in patients with head and neck malignancy warrants further investigations to ensure adequate therapy for incidental parotid lesions.

Key Points

• The prevalence of parotid incidentaloma on PET in head and neck malignancy was 2.1 %

• The malignancy rate of incidental focal parotid FDG uptake was 33.3 %

• SUV _max could not reliably differentiate malignant from benign incidental parotid lesions

Lin M, Ho Shon I, Lin P (2010) Positron emission tomography: current status and future challenges. Intern Med J 40:19–29PubMedCrossRef

Ishimori T, Patel PV, Wahl RL (2005) Detection of unexpected additional primary malignancies with PET/CT. J Nucl Med 46:752–757PubMed

Choi JY, Lee KS, Kwon OJ et al (2005) Improved detection of second primary cancer using integrated [18 F] fluorodeoxyglucose positron emission tomography and computed tomography for initial tumor staging. J Clin Oncol 23:7654–7659PubMedCrossRef

Nakamoto Y, Tatsumi M, Hammoud D, Cohade C, Osman MM, Wahl RL (2005) Normal FDG distribution patterns in the head and neck: PET/CT evaluation. Radiology 234:879–885PubMedCrossRef

Basu S, Houseni M, Alavi A (2008) Significance of incidental fluorodeoxyglucose uptake in the parotid glands and its impact on patient management. Nucl Med Commun 29:367–373PubMedCrossRef

Lee SK, Rho BH, Won KS (2009) Parotid incidentaloma identified by combined 18 F-fluorodeoxyglucose whole-body positron emission tomography and computed tomography: findings at grayscale and power Doppler ultrasonography and ultrasound-guided fine-needle aspiration biopsy or core-needle biopsy. Eur Radiol 19:2268–2274PubMedCrossRef

Wang HC, Zuo CT, Hua FC et al (2010) Efficacy of conventional whole-body 18 F-FDG PET/CT in the incidental findings of parotid masses. Ann Nucl Med 24:571–577PubMedCrossRef

Thomas R, Sharma N, Burke C, Maxwell D, Howlett DC (2010) Parotid incidentaloma detected during thoracic PET imaging: how should these lesions be managed? Br J Hosp Med (Lond) 71:292–293CrossRef

Campbell M (2005) Confidence intervals and Newcombe's method – what are they? Midwifery 21:80–83PubMedCrossRef

10.

Nakamura S, Okochi K, Murata Y, Shibuya H, Kurabayashi T (2009) [18 F]Fluorodeoxyglucose-PET/CT differentiation between physiological and pathological accumulations in head and neck. Nucl Med Commun 30:498–503PubMedCrossRef

11.

Keyes JW Jr, Harkness BA, Greven KM, Williams DW 3rd, Watson NE Jr, McGuirt WF (1994) Salivary gland tumor: pretherapy evaluation with PET. Radiology 192:99–102PubMedCrossRef

12.

Uchida Y, Minoshima S, Kawata T et al (2005) Diagnostic value of FDG PET and salivary gland scintigraphy for parotid tumors. Clin Nucl Med 30:170–176PubMedCrossRef

13.

Rubello D, Nanni C, Castellucci P et al (2005) Does 18 F-FDG PET/CT play a role in the differential diagnosis of parotid masses? Panminerva Med 47:187–189PubMed

14.

Blodgett TM, Fukui MB, Snyderman CH et al (2005) Combined PET-CT in the head and neck. Part 1. Physiologic, altered physiologic, and artifactual FDG uptake. Radiographics 25:897–912PubMedCrossRef

15.

Okamura T, Kawabe J, Koyama K et al (1998) Fluorine-18 fluorodeoxyglucose positron emission tomography imaging of parotid mass lesions. Acta Otolaryngol Suppl 538:209–213PubMed

16.

Shah VN, Branstetter BF (2007) Oncocytoma of the parotid gland: a potential false-positive finding on 18 F-FDG PET. AJR Am J Roentgenol 189:W212–W214PubMedCrossRef

17.

Ozawa N, Okamura T, Koyama K et al (2006) Retrospective review: usefulness of a number of imaging modalities including CT, MRI, technetium-99 m pertechnetate scintigraphy, gallium-67 scintigraphy and F-18-FDG PET in the differentiation of benign from malignant parotid masses. Radiat Med 24:41–49PubMedCrossRef

18.

Choi DS, Na DG, Byun HS et al (2000) Salivary gland tumors: evaluation with two-phase helical CT. Radiology 214:231–236PubMedCrossRef

19.

Lev MH, Khanduja K, Morris PP et al (1988) Parotid pleomorphic adenomas: delayed CT enhancement. AJNR Am J Neuroradiol 19:1835–1839

20.

Yerli H, Aydin E, Coskun M et al (2007) Dynamic multislice computed tomography findings for parotid gland tumors. J Comput Assist Tomogr 31:309–316PubMedCrossRef

21.

Shimizu M, Ussmüller J, Hartwein J, Donath K, Kinukawa N (1999) Statistical study for sonographic differential diagnosis of tumorous lesions in the parotid gland. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 88:226–233PubMedCrossRef

22.

Cvetinović M, Jović N, Mijatović D (1991) Evaluation of ultrasound in the diagnosis of pathologic processes in the parotid gland. J Oral Maxillofac Surg 49:147–150PubMedCrossRef

Titel: Incidental focal FDG uptake in the parotid glands on PET/CT in patients with head and neck malignancy
verfasst von: Young Lan Seo
Dae Young Yoon
Sora Baek
Kyoung Ja Lim
Eun Joo Yun
Young Kwon Cho
Woo Jin Bae
Eun Jae Chung
Kee Hwan Kwon
Publikationsdatum: 01.01.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 1/2015
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3397-1

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Incidental focal FDG uptake in the parotid glands on PET/CT in patients with head and neck malignancy