Pre-treatment metabolic tumor volume predicts tumor metastasis and progression in high-grade salivary gland carcinoma

purposehigh-grade salivary gland carcinoma (sgc) shows a high rate of metastasis and post-treatment recurrence, resulting in poor patient survival. therefore, we evaluated the utility of pre-treatment 18f-fdg pet/ct parameters in predicting metastasis, tumor progression, and survival of high-grade sgc patients. methods:this observational study included 75 patients with previously untreated high-grade sgc who underwent pre-treatment 18f-fdg pet/ct scanning and subsequent treatment. standardized uptake values (suv), metabolic tumor volume (mtv), and total lesion glycolysis (tlg) were measured on pre-treatment 18f-fdg pet/ct. logistic regression analysis was used to identify the relationship of these factors with metastasis. cox proportional hazard regression analyses were used to identify associations between pet parameters and both progression-free survival (pfs) and overall survival (os). results:a total of 36 (48%) patients had neck or distant metastases at initial staging. after controlling for clinical factors, mtv (> 8.8 ml) was an independent factor for initial metastasis (adjusted odds ratio 4.80, 95% confidence interval 1.09–21.20; p = 0.039). all pet parameters of suvmax (> 4.3), suvmean (> 3.0), suvpeak (3.9), mtv (> 8.8 ml), and tlg (> 31.1 g) were significant variables for pfs (all p < 0.05), while mtv and tlg were significant factors for os. after controlling for clinicopathological factors, mtv (adjusted hazard ratio 4.36, 95% confidence interval 1.69–11.26; p = 0.002) and tlg (3.41, 1.47–7.91; p = 0.004) were significantly associated with pfs, but not os. conclusion:smtv is useful among quantitative pet measurements for predicting initial metastasis and pfs in patients with high-grade sgc.