Open AccessDiagnostic and Prognostic Utility of 18F-FDG PET/CT in Recurrent Salivary Gland Cancers
Author(s) -
Reiko Nakajima,
Snehal G. Patel,
Nora Katabi,
Stephanie Flukes,
Audrey Mauguen,
Ian Ganly,
Heiko Schöder
Publication year - 2021
Publication title -
american journal of roentgenology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.294
H-Index - 196
eISSN - 1546-3141
pISSN - 0361-803X
DOI - 10.2214/ajr.20.23259
Subject(s) - medicine , univariate analysis , salivary gland cancer , nuclear medicine , positron emission tomography , stage (stratigraphy) , salivary gland , retrospective cohort study , radiology , lesion , proportional hazards model , pet ct , cancer , multivariate analysis , pathology , biology , paleontology
OBJECTIVE. The role of 18 F-FDG PET/CT in the evaluation of recurrent salivary gland tumors remains poorly defined. We investigated the diagnostic and prognostic utility of PET in this setting. MATERIALS AND METHODS. A total of 146 patients with recurrent salivary gland cancer were treated at our institution between January 2002 and December 2015. Patients who underwent FDG PET/CT and conventional imaging (CT or MRI) within 3 months of recurrence ( n = 78) were included in this retrospective analysis. On FDG PET/CT, we measured the SUV max , total body metabolic tumor volume of all lesions, and total lesion glycolysis of all lesions to determine the intensity and extent of FDG-avid disease. We assessed the correlation of FDG PET/CT findings with clinicopathologic features, progression-free survival, and overall survival. RESULTS. FDG PET/CT was positive for recurrence in 74 of 78 patients (94.9%) and falsely negative in four patients (5.1%). In comparison with conventional imaging, FDG PET/CT performed for restaging detected additional recurrent lesions in 14 patients (17.9%). The median SUV max was 7.4, the median total body metabolic tumor volume was 30.1 cm 3 , and median total lesion glycolysis was 97.3 g/mL × cm 3 . Sixty-six patients had progressive disease, and 54 died. Univariate and multivariate Cox hazards analysis identified pathologic risk group ( p = .04), total body metabolic tumor volume ( p < .001), and total lesion glycolysis ( p < .001) as independent prognostic factors for progression-free survival and identified age ( p = .05), total body metabolic tumor volume ( p < .001), and total lesion glycolysis ( p < .001) as independent prognostic factors for overall survival. CONCLUSION. In patients with recurrent salivary gland cancer, FDG PET/CT is useful as a single test for defining the extent of disease and providing prognostic information, which may help in selecting appropriate treatment strategies.