Is There a Role for PET/CT Parameters to Characterize Benign, Malignant, and Metastatic Parotid Tumors?

• Type of Material: Article
• Authors: Ayse Karagulle Kendi, Emory University; Kelly Magliocca, Emory University; Amanda Corey, Emory University; James Galt, Emory University; Jeffrey Switchenko, Emory University; Jeffery Wadsworth, Emory University; Mark El-Deiry, Emory University; David Schuster, Emory University; Nabil Saba, Emory University; Patricia Hudgins, Emory University
• Language: English
• Date: 2016-09-01
• Publisher: American Roentgen Ray Society (ARRS)
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © American Roentgen Ray Society.
• Final Published Version (URL): http://dx.doi.org/10.2214/AJR.15.15590
• Title of Journal or Parent Work: American Journal of Roentgenology
• ISSN: 0361-803X
• Volume: 207
• Issue: 3
• Start Page: 635
• End Page: 640
• Grant/Funding Information: Supported in part by grant P30CA138292 from the National Institutes of Health and National Cancer Institute and by the Biostatistics and Bioinformatics Shared Resource of Winship Cancer Institute of Emory University.
• Keywords: STANDARDIZED UPTAKE VALUE; Life Sciences & Biomedicine; Science & Technology; parameter; UTILITY; parotid; FDG; Radiology, Nuclear Medicine & Medical Imaging; SALIVARY-GLAND TUMORS; VOLUME; F-18-FDG PET/CT; malignant; COMPUTED-TOMOGRAPHY; benign; tumor; PET/CT
• Research Categories: Health Sciences, Radiology; Health Sciences, Pathology; Health Sciences, Oncology

Abstract

OBJECTIVE. Assessment of benign and malignant lesions of the parotid gland, including metastatic lesions, is challenging with current imaging methods. Fluorine-18 FDG PET/CT is a noninvasive imaging modality that provides both anatomic and metabolic information. Semiquantitative data obtained from PET/CT, also known as PET/CT parameters, are maximum, mean, or peak standardized uptake values (SUVs); metabolic tumor volume; total lesion glycolysis; standardized added metabolic activity; and normalized standardized added metabolic activity. Our aim was to determine whether FDG PET/CT parameters can differentiate benign, malignant, and metastatic parotid tumors. MATERIALS AND METHODS. Thirty-four patients with parotid neoplasms underwent PET/CT before parotidectomy; maximum SUV, mean SUV, peak SUV, total lesion glycolysis, metabolic tumor volume, standardized added metabolic activity, and normalized standardized added metabolic activity were calculated on a dedicated workstation. Univariate analyses were performed. A ROC analysis was used to determine the ability of PET/CT parameters to predict pathologically proven benign, malignant, and metastatic parotid gland neoplasms. RESULTS. Fourteen patients had a benign or malignant primary parotid tumor. Twenty had metastases to the parotid gland. When the specificity was set to at least 85% for each parameter to identify cut points, the corresponding sensitivities ranged from 15% to 40%. Assessment of benign versus malignant lesions of parotid tumors, as well as metastasis from squamous cell carcinoma versus other metastatic causes, revealed that none of the PET/CT parameters has enough power to differentiate among these groups. CONCLUSION. PET/CT parameters, including total lesion glycolysis, metabolic tumor volume, standardized added metabolic activity, and normalized standardized added metabolic activity, are not able to differentiate benign from malignant parotid tumors, primary parotid tumors from metastasis, or metastasis from squamous cell carcinoma and nonsquamous cell carcinoma metastasis.