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Current Medical Imaging

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ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

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Research Article

The Clinical Significance of Incidental Parotid Uptake in a PET/CT Study: A Diagnostic Algorithm

Author(s): Funda Üstün*, Ebru Taştekin, Abdullah Taş and Gülay Durmuş Altun

Volume 15, Issue 3, 2019

Page: [326 - 333] Pages: 8

DOI: 10.2174/1573405614666171213160244

Price: $65

Abstract

Background: Patients diagnosed with cancer do not have sufficient clinical data for the management of incidental parotid lesions. We aimed to reveal the importance of randomized parotid lesions encountered during oncologic F-18 fluorodeoxyglucose positron emission tomography (FDG PET/CT) imaging in our clinical practice and the diagnostic algorithm of such lesions.

Methods: We performed a database search of PET/CT records generated from 2009 to 2015 for “parotid” in reports of patients who underwent PET/CT examination for a known malignancy elsewhere, or cancer screening.

Results: Incidental parotid FDG uptake on PET/CT had a prevalence of 1.1%. The incidence of parotid metastasis in our series was 36.4%, and 75% of them had malign melanoma metastasis. Of the 11 cases, 5 were of Warthin tumours, and Warthin tumours showed stronger GLUT1 expression than metastatic parotid lesions.

Conclusion: In patients with malignancy elsewhere, focal involvement of FDG by the parotid gland, especially if malignant melanoma or SCC is absent, should not be considered a metastatic disease without histopathologic confirmation. If parotid disease would change the patient’s treatment plan and disease stage, the parotid lesion should be evaluated by additional methods, such as fine needle aspiration biopsy.

Keywords: Incidentaloma, parotis, warthin, FDG PET/CT, metastatic, cancer screening.

Graphical Abstract

[1]
Uchida Y, Minoshima S, Kawata T, et al. Diagnostic value of FDG PET and salivary gland scintigraphy for parotid tumors. Clin Nucl Med 2005; 30(3): 170-6.
[2]
Seo YL, Yoon DY, Baek S, et al. Incidental focal FDG uptake in the parotid glands on PET/CT in patients with head and neck malignancy. Eur Radiol 2015; 25(1): 171-7.
[3]
Bothe C, Fernandez A, Garcia J, et al. Parotid incidentaloma identified by positron emission/computed tomography: When to consider diagnoses other than warthin tumor. Int Arch Otorhinolaryngol 2015; 19(2): 112-5.
[4]
Horiuchi M, Yasuda S, Shohtsu A, Ide M. Four cases of Warthin’s tumor of the parotid gland detected with FDG PET. Ann Nucl Med 1998; 12(1): 47-50.
[5]
Klijanienko J, Petras S, De Bosschere L, Paulmier B, Le Tourneau C, Rodriguez J. False-positive FDG PET/CT uptake in Warthin tumor in head and neck oncological patients confirmed by a fine needle aspiration. Diagn Cytopathol 2012; 40(3): 282-4.
[6]
Fang T, Zhu J, Chuan L, Zhao W, Liang Y, Wang S. DifferentialDiagnosis of Warthin’s tumor complicated with lung adenocarcinoma by 18F- FDG PET/CT imaging and radioisotope scanning with Tc-99m pertechnetate: A case report and literature review. Chin J Cancer Res 2010; 22(2): 163-6.
[7]
Shah VN, Branstetter BF. Oncocytoma of the parotid gland: A potential false-positive finding on 18F-FDG PET. AJR 2007; 189(4): W212-14.
[8]
Koch A, Lang SA, Wild PJ, et al. Glucose transporter isoform 1 expression enhances metastasis of malignant melanoma cells. Oncotarget 2015; 6(32): 32748-60.
[9]
Mabray MC, Behr SC, Naeger DM, Flavell RR, Glastonbury CM. Predictors of pathologic outcome of focal FDG uptake in the parotid gland identified on whole-body FDG PET imaging. Clin Imaging 2015; 39(6): 1073-9.
[10]
Bron LP, Traynor SJ, McNeil EB, O’Brien CJ. Primary and metastatic cancer of the parotid: Comparison of clinical behavior in 232 cases. Laryngoscope 2003; 113: 1070-5.
[11]
Pomar Blanco P, Martín Villares C, San Román Carbajo J. TapiaRisueño M, Fernández Pello M. Metastasis to the parotid gland. Acta Otorrinolaringol Esp 2006; 57(1): 47-50.
[12]
P. Suton. I. Luksˇic´, D. Mu¨ller, M. Virag: Lymphatic drainage patterns of head and neck cutaneous melanoma: Doesprimary melanoma site correlate with anatomic distribution of pathologically involved lymph nodes? Int J Oral Maxillofac Surg 2012; 41: 413-20.
[13]
Rassekh CH, Cost JL, Hogg JP, Hurst MK, Marano GD, Ducatman BS. Positron emission tomography in Warthin’s tumor mimicking malignancy impacts the evaluation of head and neck patients. Am J Otolaryngol 2015; 36(2): 259-63.
[14]
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(4): 367-73.
[15]
Lee SK, Rho BH, Won KS. Parotid incidentaloma identified by combined 18F-fluorodeoxyglucose whole-body positron emissiontomography and computed tomography: Findings at gray scale and power Doppler ultrasonography and ultrasound-guided fine-needle aspiration biopsy or core-needle biopsy. Eur Radiol 2009; 19(9): 2268-74.
[16]
Toriihara A, Nakamura S, Kubota K, Makino T, Okochi K, Shibuya H. Can dual-time-point 18F-FDG PET/CT differentiate malignant salivary gland tumors from benign tumors? AJR Am J Roentgenol 2013; 201(3): 639-44.
[17]
Ozawa N, Okamura T, Koyama K, 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(1): 41-9.
[18]
Burgess AN, Serpell JW. Parotidectomy: Preoperative investigations and outcomes in a single surgeon practice. ANZ J Surg 2008; 78(9): 791-3.
[19]
Dăguci L, Simionescu C, Stepan A, Munteanu C, Dăguci C, Bătăiosu M. Warthin tumor-morphological study of the stromalcompartment. Rom J Morphol Embryol 2011; 52(4): 1319-23.
[20]
Chedid HM, Rapoport A, Aikawa KF. MenezesAdos S, Curioni OA. Warthin’s tumor of the parotid gland: Study of 70 cases. Rev Col Bras Cir 2011; 38(2): 90-4.
[21]
Teymoortash A, Krasnewicz Y, Werner JA. Clinical features of cystadenol ymphoma (Warthin’s tumor) of the parotid gland: A retrospective comparative study of 96 cases. Oral Oncol 2006; 42(6): 569-73.
[22]
Maiorano E, LoMuzio L, Favia G, Piattelli A. Warthin’s tumour: A study of 78 cases with emphasis on bilaterality, multifocality and association with other malignancies. Oral Oncol 2002; 38(1): 35-40.
[23]
O’Neill ID. New insights into the nature of Warthin’s tumour. J Oral Pathol Med 2009; 38(1): 145-9.
[24]
Takezawa K, Jackson C, Gnepp DR, King TC. Molecular characterization of Warthin tumor. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998; 85(5): 569-75.
[25]
Aguirre JM, Echebarría MA, Martínez-Conde R, Rodriguez C, Burgos JJ, Rivera JM. Warthin tumor. A new hypothesis concerning its development. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998; 85(1): 60-3.
[26]
Avril N. GLUT1 expression in tissue and (18)F-FDG uptake. J Nucl Med 2004; 45(6): 930-2.
[27]
Horiuchi C, Tsukuda M, Taguchi T, Ishiguro Y, Okudera K, Inoue T. Correlation between FDG-PET findings and GLUT1 expression in salivary gland pleomorphic adenomas. Ann Nucl Med 2008; 22(8): 693-8.
[28]
Teymoortash A, Schrader C, Shimoda H, Kato S, Werner JA. Evidence of lymphangiogenesis in Warthin’s tumor of the parotid gland. Oral Oncol 2007; 43(6): 614-8.
[29]
White CK, Williams KA, Rodriguez-Figueroa J, Langer CJ. Warthin’s tumors and their relationship to lung cancer. Cancer Invest 2015; 33(1): 1-5.
[30]
Treglia G, Bertagna F, Sadeghi R, Muoio B, Giovanella L. Prevalence and risk of malignancy of focal incidental uptake detected by fluorine-18-fluorodeoxyglucose positron emission tomography in the parotid gland: A meta-analysis. Eur Arch Otorhinolaryngol 2015; 272(12): 3617-26.

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