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DOI: 10.1055/s-0032-1312272
Utility of 18-FDG-PET in the Initial Diagnosis and Workup of Sinonasal Malignancy
Introduction: The utility of 18-FDG-PET has been gradually defined for most head and neck cancers, and is frequently used for surveillance after therapy for sinonasal malignancies. PET scanning has not been extensively studied in the initial diagnosis of sinonasal malignancy, but may prove helpful for diagnosis and treatment planning. The aim of this study is to determine if PET scanning can accurately diagnose malignant sinonasal lesions and identify the presence of regional or distant metastasis.
Methods: A retrospective chart analysis was conducted of 36 cases of sinonasal malignancy in patients who underwent PET scan at the time of diagnosis. Maximum standard uptake values (SUVmax) were recorded for the primary site as correlated with CT and/or MRI, and the detection of metastasis was documented.
Results: Thirty-six patients with sinonasal malignancies underwent diagnostic whole-body PET or PET-CT scans;. 30/36 had a mean SUVmax of 13.9 (range, 3.2–58.0). Three patients were found to have intensely avid uptake in which the SUVmax was not documented, and three had no uptake in the region of their malignancies. Whole-body PET scan at tumor presentation detected metastasis in 25% (9/36).
Conclusions: The use of PET scanning has become more prevalent in head and neck cancer. For diagnosis of sinonasal malignancy, it appears to be quite reliable, although false-negatives may occur. Metastasis was detected in 25% of patients, suggesting a role for PET scanning in the diagnosis and treatment planning of malignant sinonasal lesions.