18F-FDG PET/CT for Surveillance in Salivary Gland Cancers: A Systematic Review and Meta-Analysis.

Abstract

To evaluate the diagnostic accuracy of 18F-FDG-PET/CT compared to conventional imaging modalities (CIM) to detect recurrence of primary salivary gland cancers (SGCs). Review performed on December 26, 2024, using Embase, CINHAL, MEDLINE, and PubMed. Two blinded reviewers selected studies reporting diagnostic accuracy of PET/CT in identifying locoregional recurrence and/or metastasis in patients with SGCs. The analysis was performed adhering to PRISMA guidelines using R 4.3.3. Pooled analysis with 95% confidence intervals (CI) were analyzed. A total of 12 studies were retained from the systematic review, including 264 patients evaluated in the meta-analysis. For local recurrence, there was a pooled sensitivity of 0.86 (95% CI 0.73-0.93) and a pooled specificity of 0.95 (95% CI 0.92-0.97) for PET/CT, and a pooled sensitivity of 0.89 (95% CI 0.80-0.94) and a pooled specificity of 0.91 (95% CI 0.79-0.97) for CIM (p = 0.90). For regional metastasis, there was a pooled sensitivity of 0.90 (95% CI 0.73-0.97) and a pooled specificity of 0.96 (95% CI 0.92-0.98) for PET/CT, and a pooled sensitivity of 0.80 (95% CI 0.62-0.91) and a pooled specificity of 0.95 (0.90-0.98) for CIM (p = 0.26). For distant metastasis, there was a pooled sensitivity of 0.96 (95% CI 0.90-0.99) and a pooled specificity of 0.95 (95% CI 0.85-0.98) for PET/CT, and a pooled sensitivity of 0.80 (95% CI 0.71-0.86) and a pooled specificity of 0.97 (95% CI 0.87-0.99) for CIM (p = 0.018). 18F-FDG-PET/CT imaging is accurate for the detection of SGC recurrence, particularly for the detection of regional and distant metastases. NA Laryngoscope, 135:1884-1898, 2025.