Skip to main content
SpringerLink
Log in

Efficacy of conventional whole-body 18F-FDG PET/CT in the incidental findings of parotid masses

  • Original Article
  • Published:
Annals of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Objective

The objective of this study was to evaluate the incidence of incidental parotid masses with conventional whole-body 18F-deoxyglucose (FDG) PET/CT and assess the ability of PET/CT to characterize these unexpected parotid lesions.

Methods

Fifty eight incidental findings of parotid masses with routine FDG PET/CT whole-body scan were reviewed in this retrospective analysis, which were selected from the patients without any known or suspected parotid disease in our PET center, from June 2005 to May 2009. 51 cases were operated or underwent a biopsy after a short-term PET/CT study; the remaining 7 cases had a follow-up. Parotid mass that showed both noncontrast CT (irregular shape and blurry border) and PET malignant features (high FDG uptake, SUVmax > 3.0) was considered as positive for malignancy. Correlation of FDG PET/CT with histology or follow-up outcome was performed.

Results

Fifty eight unexpected findings of parotid masses accounted for 0.3% of the total cases in 4 years, including 11 (19.0%) malignant tumors and 47 (81.0%) benign lesions. 13 lesions manifested single nodule with malignant CT features and intense FDG activity, of which 6 were proved to be malignant; thus, sensitivity and positive predictive values were 54.5% (6 of 11) and 46.2% (6 of 13), respectively. 45 lesions showed either single nodule with benign CT features, or a low FDG uptake (SUVmax ≤ 3.0), of which 40 were true negatives; therefore, specificity and negative predictive values were 85.1% (40 of 47) and 88.9% (40 of 45), respectively. All parotid masses except 9 benign and 1 malignant showed a high FDG uptake. Compared with SUV only, combined interpretation of PET and CT results displayed a lower sensitivity (90.9–54.5%), but a higher specificity (19.1–85.1%) and a higher overall accuracy.

Conclusions

Whole-body FDG-PET/CT at the time of surveying the entire body condition is helpful for detecting the asymptomatic parotid masses. Combined noncontrast CT is an essential evidence for improving the diagnostic accuracy of FDG-PET/CT for parotid masses.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Lee YYP, Wong KT, King AD, Ahuja AT. Imaging of salivary gland tumours. Eur J Radiol. 2008;66:419–36.

    Article  CAS  PubMed  Google Scholar 

  2. Mehta A, Bansal SC. Diagnosis and management of cancer. Jaypee Brothers Medical Publishers (P) Ltd.; 2004. p. 232–52.

  3. Lin CC, Tsai MH, Huang CC, Hua CH, Tseng HC, Huang ST. Parotid tumors: a 10-year experience. Am J Otolaryngol. 2008;29:94–100.

    Article  PubMed  Google Scholar 

  4. Burgess AN, Serpell GW. Parotidectomy: preoperative investigations and outcomes in a single surgeon practice. ANZ J Surg. 2008;78:791–3.

    Article  PubMed  Google Scholar 

  5. Subhashraj K. Salivary gland tumors: a single institution experience in India. Br J Oral Maxillofac Surg. 2008;46:635–8.

    Article  PubMed  Google Scholar 

  6. Even-Sapir E, Lerman H, Gutman M, Lievshitz G, Zuriel L, Polliack A, et al. The presentation of malignant tumours and pre-malignant lesions incidentally found on PET-CT. Eur J Nucl Med Mol Imaging. 2006;33:541–52.

    Article  PubMed  Google Scholar 

  7. Ishimori T, Patel PV, Wahl RL. Detection of unexpected additional primary malignancies with PET/CT. J Nucl Med. 2005;46:752–7.

    PubMed  Google Scholar 

  8. Adriaensen M, Schijf L, Haas M, Huijbregts J, Baarslag HJ, Staaks G, et al. Six synchronous primary neoplasms detected by FDG-PET/CT. Eur J Nucl Med Mol Imaging. 2008;35:1931.

    Article  PubMed  Google Scholar 

  9. Choi JY, Lee KS, Kwon OJ, Shim YM, Baek CH, Park K, et al. Improved detection of second primary cancer using integrated [18F] fluorodeoxyglucose positron emission tomography and computed tomography for initial tumor staging. J Clin Oncol. 2005;23:7654–9.

    Article  PubMed  Google Scholar 

  10. De Wever W, Vankan Y, Stroobants S, Verschakelen J. Detection of extrapulmonary lesions with integrated PET/CT in the staging of lung cancer. Eur Respir J. 2007;29:995–1002.

    Article  PubMed  Google Scholar 

  11. Branstetter BF, Blodgett TM, Zimmer LA, Synderman CH, Johnson JT, Raman S, et al. Head and neck malignancy: is PET/CT more accurate than PET or CT alone? Radiology. 2005;235:580–6.

    Article  PubMed  Google Scholar 

  12. Bar-Shalom R, Yefremov N, Guralnik L, Gaitini D, Frenkei A, Kuten A, et al. Clinical performance of PET/CT in evaluation of cancer: additional value for diagnostic imaging and patient management. J Nucl Med. 2003;44:1200–9.

    PubMed  Google Scholar 

  13. Uchida Y, Minoshima S, Kawata T, Motoori K, Nakano K, Kazama T, et al. Diagnostic value of FDG PET and salivary gland scintigraphy for parotid tumors. Clin Nucl Med. 2005;30:170–6.

    Article  PubMed  Google Scholar 

  14. Okamura T, Kawabe J, Koyama K, Ochi H, Yamada R, Sakamoto H, et al. Fluorine-18 fluorodeoxyglucose positron emission tomography imaging of parotid mass lesions. Acta Otolaryngol Suppl. 1998;538:209–13.

    Article  CAS  PubMed  Google Scholar 

  15. Basu S, Houseni M, Alavi A. Significance of incidental fluorodeoxyglucose uptake in the parotid glands and its impact on patient management. Nucl Med Commun. 2008;29:367–73.

    Article  CAS  PubMed  Google Scholar 

  16. Rumboldt D, Gordon L, Bonsall R, Ackermann S. Imaging in head and neck cancer. Curr Treat Options Oncol. 2006;7:23–34.

    Article  PubMed  Google Scholar 

  17. Keyes JW, Harkness BA, Greven KM, Williams DW, Watson NE, Frederick-McGuirt W. Salivary gland tumors: pretherapy evaluation with PET. Radiology. 1994;192:99–102.

    PubMed  Google Scholar 

  18. Shah VN, Branstetter BF. Oncocytoma of the parotid gland: a potential false-positive finding on 18F-FDG PET. Am J Roentgenol. 2007;189:W212–4.

    Article  Google Scholar 

  19. Rubello D, Nanni C, Castellucci P, Rampin L, Farsad M, Franchi R, et al. Does 18F-FDG PET/CT play a role in the differential diagnosis of parotid masses. Panminerva Med. 2005;47:187–9.

    CAS  PubMed  Google Scholar 

  20. Ozawa N, Okamura T, Koyama K, Nakayama K, Kawabe J, Shiomi S, et al. 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. Radiat Med. 2006;24:41–9.

    Article  PubMed  Google Scholar 

  21. Lim CY, Chang HC, Nam KH, Chung WY, Park CS. Preoperative prediction of the location of parotid gland tumors using anatomical landmarks. World J Surg. 2008;32:2200–3.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. PET Center, Huashan Hospital, Fudan University, 518 East Wuzhong Road, Shanghai, 200235, China

    Hui-Chun Wang, Chuan-Tao Zuo, Feng-Chun Hua, Zhe-Min Huang, Hai-Bo Tan, Jun Zhao & Yi-Hui Guan

Authors
  1. Hui-Chun Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chuan-Tao Zuo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Feng-Chun Hua
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Zhe-Min Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hai-Bo Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jun Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yi-Hui Guan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yi-Hui Guan.

Additional information

H.-C. Wang and C.-T. Zuo contributed equally to this work.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wang, HC., Zuo, CT., Hua, FC. et al. Efficacy of conventional whole-body 18F-FDG PET/CT in the incidental findings of parotid masses. Ann Nucl Med 24, 571–577 (2010). https://doi.org/10.1007/s12149-010-0394-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12149-010-0394-6

Keywords

Search

Navigation