Allergy/Rhinology

18-FDG-PET in the initial staging of sinonasal malignancy

Corresponding Author

Vijay R. Ramakrishnan MD

Department of Otorhinolaryngology–Head and Neck Surgery, University of Colorado, Denver, Colorado

Send correspondence to Vijay R. Ramakrishnan, MD, Department of Otolaryngology–Head and Neck Surgery, University of Colorado, 12631 E. 17th Ave., B205, Aurora, CO 80045. E-mail: [email protected]Search for more papers by this author

Jennifer Y. Lee MD,

Jennifer Y. Lee MD

Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania

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Bert W. O'Malley Jr. MD,

Bert W. O'Malley Jr. MD

Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania

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James N. Palmer MD,

James N. Palmer MD

Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania

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Alexander G. Chiu MD,

Alexander G. Chiu MD

Department of Otorhinolaryngology–Head and Neck Surgery, University of Arizona, Tucson, Arizona, U.S.A

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Vijay R. Ramakrishnan MD,

Corresponding Author

Vijay R. Ramakrishnan MD

Department of Otorhinolaryngology–Head and Neck Surgery, University of Colorado, Denver, Colorado

Jennifer Y. Lee MD,

Jennifer Y. Lee MD

Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania

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Bert W. O'Malley Jr. MD,

Bert W. O'Malley Jr. MD

Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania

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James N. Palmer MD,

James N. Palmer MD

Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania

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Alexander G. Chiu MD,

Alexander G. Chiu MD

Department of Otorhinolaryngology–Head and Neck Surgery, University of Arizona, Tucson, Arizona, U.S.A

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First published: 23 July 2013

https://doi.org/10.1002/lary.24317

Citations: 19

The authors have no funding, financial relationships, or conflicts of interest to disclose.

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Abstract

Objectives/Hypothesis

The utility of fluorine-18 fluorodeoxyglucose-positron emission tomography (PET) has been gradually defined for most head and neck cancers, However, its utility in the initial diagnosis of sinonasal malignancy has not been extensively studied. The aim of this study was to determine if PET scanning accurately diagnoses and stages malignant sinonasal lesions and if maximum standard uptake value (SUV_max) correlates with clinically advanced disease.

Study Design

Retrospective chart review.

Methods

There were 51 patients with sinonasal malignancy who underwent diagnostic whole body PET or PET-computed tomography scans that were analyzed for patient and disease characteristics, SUV_max, and staging.

Results

Of the 51 patients, 48 scans were positive at the primary site, with a sensitivity of 94%. Four patients were found to have intensely avid uptake, in which the numerical SUV_max was not documented, and three patients did not have any uptake in the region of their tumor. Mean SUV_max at the primary site was 16.1 (range, 3.1–59). Metastasis was detected in 31% (16/51) of the patients. There was a potential positive correlation between SUV_max at the primary site and detection of metastasis on univariate analysis (r = 0.19, P = .09), but on multivariate analysis, SUV_max was not found to correlate with T staging or metastasis.

Conclusions

For diagnosis of sinonasal malignancy, PET scans have a high sensitivity, although false negatives occurred in 6% of cases. PET scanning detected metastasis in 31% of patients, but SUV_max did not function as a marker for clinically advanced disease. The role of diagnostic PET for sinonasal malignancy is currently limited to cases with a high suspicion of metastatic disease.

Level of Evidence

NA Laryngoscope, 123:2962–2966, 2013

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Citing Literature

Volume123, Issue12

December 2013

Pages 2962-2966

18-FDG-PET in the initial staging of sinonasal malignancy

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusions

Level of Evidence

BIBLIOGRAPHY

Citing Literature

References

Information

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18-FDG-PET in the initial staging of sinonasal malignancy

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusions

Level of Evidence

BIBLIOGRAPHY

Citing Literature

References

Related

Information