title: 18-FDG-PET in the initial staging of sinonasal malignancy.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Colorado, Denver, Colorado.
authors.forename: Vijay R
authors.initials: VR
authors.lastname: Ramakrishnan
authors.forename: Jennifer Y
authors.initials: JY
authors.lastname: Lee
authors.forename: Bert W
authors.initials: BW
authors.lastname: O'Malley
authors.forename: James N
authors.initials: JN
authors.lastname: Palmer
authors.forename: Alexander G
authors.initials: AG
authors.lastname: Chiu
mesh_terms: D000328:Adult; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D009367:Neoplasm Staging / Q000379:methods*; D009669:Nose Neoplasms / Q000000981:diagnostic imaging*; D010255:Paranasal Sinus Neoplasms / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Sinus tumor; malignancy; metastatic cancer; positron emission tomography scan; sinonasal malignancy; sinonasal tumor; skull base malignancy; skull base tumor