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A Journal on Internal Medicine


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ORIGINAL ARTICLES  


Panminerva Medica 2005 September;47(3):187-9

language: English

Does 18F-FDG PET/CT play a role in the differential diagnosis of parotid masses

Rubello D. 1, Nanni C. 2, Castellucci P. 2, Rampin L. 1, Farsad M. 2, Franchi R. 2, Mariani G. 3, Menaldo G. 4, Fanti S. 2

1 PET Unit, Department of Nuclear Medicine S. Maria della Misericordia Hospital, Rovigo, Italy
2 PET Unit, Department of Nuclear Medicine S. Orsola-Malpighi, University of Bologna, Bologna, Italy
3 Regional Center of Nuclear Medicine University of Pisa, Pisa, Italy
4 Department of Otorhinolaryngology S. Maria della Misericordia, Rovigo Hospital, Rovigo, Italy


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Aim. The aim of the present study was to assess the accuracy of an hybrid PET/CT scanner in the evaluation of newly diagnosed parotid masses, comparing the results with those reported in the literature with using PET scanners only.
Methods. The potential role of 18F-FDG PET/CT in distinguishing benign from malignant parotid masses in 14 consecutive patients was investigated. All patients were preoperatively evaluated by means of ultrasound (US), US-guided fine needle aspiration (FNA) cytology, computed tomography (CT) scan, magnetic resonance imaging (MRI) and 18F-FDG PET/CT. For To interpreting FDG PET findings, the right to left parotid (R/L) SUV max ratio was calculated in a group of 54 patients without evidence of parotideal disease (mean±SD = 1±0.2; range = 0.8-1.2); considering the R/L SUV max ratio, focal or diffuse uptakes <0.8 or >1.2 were considered as potentially pathological.
Results. Imaging data were compared with surgical and histopathological findings. At FDG PET/CT, 9 false positive cases were found (8 Warthin’s tumours, 1 pleomorphic adenoma), 1 false negative (acinar cell carcinoma), 4 true negative (1 Warthin’s tumour, 1 pleomorphic adenoma, 1 lymph epithelial cyst, 1 parotid inflammation) whereas there was no case of true positive. The global accuracy of FGD PET/CT was rather low = at 29%.
Conclusion. In agreement with other preliminary reports in which the FDG PET without CT fusion imaging was used, in our experience 18F-FDG PET/CT did not prove to play a significant role in differential diagnosis (benign vs malignant) of parotid masses. Further studies collecting larger groups of patients are needed to further elucidate this observation.

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