Performance of whole-body 18F-FDG PET/CT as a posttreatment surveillance tool for sinonasal malignancies
To determine the diagnostic utility of posttreatment surveillance whole-body 18F-FDG PET/CT in detecting local tumor recurrence (R), regional lymph-node metastasis (LM), and distant metastasis (DM) in asymptomatic sinonasal cancer patients.
Eighty consecutive patients (53 men, 27 women; mean age, 60 years; range, 28–92 years) who had undergone 197 posttreatment whole-body 18F-FDG PET/CT examinations for sinonasal malignancies between January 2009 and August 2017 were retrospectively reviewed. 18F-FDG PET/CT findings were categorized as positive or negative for R, LM, and DM, separately. Outcomes of 18F-FDG PET/CT scans were compared with the final diagnosis confirmed by histological analysis or follow-up period for a minimum 12 months. The diagnostic accuracy of scans was calculated for each site using contingency tables. Impact on the management of 18F-FDG PET/CT examinations was additionally evaluated.
18F-FDG PET/CT scans identified 37/44 of local recurrences, 21/23 of LMs, and 30/37 of DMs. For local recurrence, sensitivity, specificity, positive predictive value, and negative predictive value were 84% (68–97%), 95% (80–100%), 84% (68–97%), and 95% (80–100%), respectively. For LM, the respective values were 91% (75–100%), 99% (83–100%), 91% (75–100%), and 99% (83–100%). For DM, the values were 81% (64–97%), 99% (85–100%), 97% (81–100%), and 96% (81–100%), respectively. 18F-FDG PET/CT accounted for a change in management of 85% patients with recurrences.
Whole-body 18F-FDG PET/CT is a suitable surveillance tool for sinonasal malignancies in detecting locoregional and distant recurrences in asymptomatic patients without any evidence of recurrence on regular follow-up and endoscopy during the posttreatment period.
Keywords18F-FDG PET/CT Sinonasal malignancies Surveillance Recurrence Posttreatment
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Conflict of interest
All authors of this manuscript, Kerem Ozturk, Mehmet Gencturk, Emiro Caicedo-Granados, Faqian Li, Zuzan Cayci declare that they have no conflict of interest.
All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1983 revised Helsinki declaration and its later amendments or comparable ethical standards.