title: Endoscopy versus imaging: Analysis of surveillance methods in sinonasal malignancy.
abstract: The purpose of this study was to assess the utility of imaging and endoscopy in posttreatment surveillance of sinonasal malignancies.
  
  
  
  We conducted a retrospective analysis of primary sinonasal malignancies diagnosed between 2000 and 2014. Posttreatment surveillance included nasal endoscopy and imaging (MRI, CT, and positron emission tomography [PET]/CT). Positive predictive value (PPV), negative predictive value (NPV), specificity, and sensitivity were calculated for each modality and compared.
  
  
  
  One hundred nine sinonasal malignancies were identified with 30 recurrences. Endoscopy showed a sensitivity and specificity of 24% and 89%, respectively, whereas imaging was 76% and 90%, respectively. Identifying suspicious symptoms significantly improved the PPV of both endoscopy and imaging. MRI demonstrates the highest PPV when compared with other imaging modalities.
  
  
  
  Both modalities are necessary in posttreatment surveillance. MRI shows the highest PPV, whereas endoscopy trends toward a higher specificity. PET/CT scans have a high false-positive rate and should be reserved for tumors with a high propensity for distant metastases. © 2016 Wiley Periodicals, Inc. Head Neck 38:1229-1233, 2016.
authors.affiliation: Division of Rhinology, Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Sammy
authors.initials: S
authors.lastname: Khalili
authors.affiliation: Division of Rhinology, Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Worrall
authors.affiliation: Division of Rhinology, Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Steve
authors.initials: S
authors.lastname: Brooks
authors.affiliation: Division of Rhinology, Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Shane M
authors.initials: SM
authors.lastname: Morris
authors.affiliation: Division of Rhinology, Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Douglas
authors.initials: D
authors.lastname: Farquhar
authors.affiliation: Division of Rhinology, Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Jason G
authors.initials: JG
authors.lastname: Newman
authors.affiliation: Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Kim O
authors.initials: KO
authors.lastname: Learned
authors.affiliation: Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Ahn
authors.affiliation: Division of Rhinology, Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: John
authors.initials: J
authors.lastname: Craig
authors.affiliation: Division of Rhinology, Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: David W
authors.initials: DW
authors.lastname: Kennedy
authors.affiliation: Division of Rhinology, Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Bert W
authors.initials: BW
authors.lastname: O'Malley
authors.affiliation: Division of Rhinology, Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: James N
authors.initials: JN
authors.lastname: Palmer
authors.affiliation: Division of Rhinology, Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Nithin D
authors.initials: ND
authors.lastname: Adappa
mesh_terms: D000328:Adult; D000368:Aged; D003952:Diagnostic Imaging / Q000706:statistics & numerical data*; D004724:Endoscopy / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000453:epidemiology; D009669:Nose Neoplasms / Q000469:parasitology / Q000628:therapy; D010255:Paranasal Sinus Neoplasms / Q000473:pathology / Q000628:therapy*; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult
keywords: endoscopy; malignancy; recurrence; sinonasal; surveillance