Cermik Tevfik Fikret, Mavi Ayse, Acikgoz Gunsel, Houseni Mohamed, Dadparvar Simin, Alavi Abass
Department of Radiology, Division of Nuclear Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
Clin Nucl Med. 2007 Apr;32(4):286-91. doi: 10.1097/01.rlu.0000257336.69537.cb.
The aim of this study was to assess the role of PET in the management of patients with primary malignant salivary gland (SG) tumor.
Sixty-one FDG PET studies in 48 patients (median age 58, range 28-89 years, 20 female, 28 male) who were diagnosed with malignant SG tumors were retrospectively analyzed. Thirteen were referred for initial diagnosis and staging while there was a suspicion of recurrence and/or metastatic disease in 48 patients during the follow-up period.
On PET examinations of 13 patients on initial presentation, 12 showed increased uptake in the primary lesion, while conventional methods (CT, MRI) were positive in 11 and were equivocal for 2 patients. Six patients with multiple nodal and 2 patients with distant metastases were detected by PET. Conventional methods demonstrated lymph node metastases in 5 of these patients. In the follow-up patient group, PET was inaccurate (false-negative or positive) in 4 (8%) patients with local recurrence, and in 4 (8%) with metastatic disease. However, 15 (31%) studies for recurrence and 7 (15%) for metastasis were false-negative with conventional radiologic methods. The sensitivity, specificity, and positive and negative predictive values for the detection of recurrent disease were 83%, 93%, 63%, and 98% for PET; 67%, 69%, 24%, and 94% for conventional methods, respectively. Overall sensitivity, specificity, positive and negative predictive values of PET for detecting metastatic disease were 93%, 96%, 82%, and 99%, while those of conventional methods were 80%, 95%, 75%, and 96%, respectively.
These results demonstrate that FDG PET is not only superior to CT and/or MRI for staging at the initial presentation but also superior to conventional imaging methodologies for detecting local recurrence and regional lymph node and distant metastases in patients with malignant SG tumor.
本研究旨在评估正电子发射断层显像（PET）在原发性恶性涎腺肿瘤患者管理中的作用。
回顾性分析了48例被诊断为恶性涎腺肿瘤患者（中位年龄58岁，范围28 - 89岁，女性20例，男性28例）的61次氟代脱氧葡萄糖（FDG）PET检查。13例因初步诊断和分期前来检查，48例在随访期间怀疑有复发和/或转移疾病。
在13例初诊患者的PET检查中，12例原发灶摄取增加，而传统方法（CT、MRI）在11例中呈阳性，2例结果不明确。PET检测到6例有多处淋巴结转移和2例有远处转移的患者。传统方法在其中5例患者中显示有淋巴结转移。在随访患者组中，PET对4例（8%）局部复发患者和4例（8%）有转移疾病患者的检测不准确（假阴性或假阳性）。然而，15例（31%）复发研究和7例（15%）转移研究采用传统放射学方法为假阴性。PET检测复发性疾病的敏感性、特异性、阳性预测值和阴性预测值分别为83%、93%、63%和98%；传统方法分别为67%、69%、24%和94%。PET检测转移疾病的总体敏感性、特异性、阳性预测值和阴性预测值分别为93%、96%、82%和99%，而传统方法分别为80%、95%、75%和96%。
这些结果表明，FDG PET不仅在初诊分期方面优于CT和/或MRI，而且在检测恶性涎腺肿瘤患者局部复发、区域淋巴结及远处转移方面也优于传统成像方法。
