title: Temporal patterns of18F-fluorodeoxyglucose positron emission tomography/computed tomography sinonasal uptake after treatment of sinonasal malignancy.
abstract: Current guidelines have identified 10 to 12 weeks posttreatment as the ideal time-point for improved diagnostic accuracy of positron emission tomography/computed tomography (PET/CT) for deep tissue sites of the head and neck. After treatment, the sinonasal skull base is predisposed to prolonged inflammation that may render this time-point inappropriate for initial posttreatment imaging surveillance for sinonasal malignancies. The purpose of this study is to evaluate temporal trends in18F-fluorodeoxyglucose (18FDG) sinonasal uptake after treatment for sinonasal malignancies to better elucidate the optimal time-point for initial PET/CT posttreatment evaluation in this patient population.
  
  
  
  A retrospective analysis of all successfully treated and non-locally recurrent sinonasal malignancies over a 15-year study period (2000 to 2015) was performed at our institution. Posttreatment18FDG PET/CT standardized uptake value data were collected and compared between various time-points (2 to 4 months, 5 to 12 months, 5 to 24 months, and 13 to 24 months) using an independent-samples t test.
  
  
  
  A statistically significant difference was noted between the posttreatment time windows 2 to 4 and 5 to 12 months (p = 0.048) as well as 2 to 4 and 5 to 24 months (p = 0.02). A trend toward significance was seen when comparing 2 to 4 and 13 to 24 months (p = 0.083).
  
  
  
  Our analysis of PET/CT in patients previously treated for sinonasal malignancy suggests that the posttreatment sinonasal skull base is characterized by a prolonged period of hypermetabolism that endures beyond the period previously described for deep tissue sites of the head and neck. These findings prompt a reevaluation of the previously described 10- to 12-week cutoff point for initial posttreatment PET/CT for head and neck squamous cell carcinoma as applied to sinonasal malignancies.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Schwartz
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.
authors.forename: Steven G
authors.initials: SG
authors.lastname: Brooks
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Stubbs
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.
authors.forename: Ankona
authors.initials: A
authors.lastname: Ghosh
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.
authors.forename: Bobby A
authors.initials: BA
authors.lastname: Tajudeen
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.|Department of Otorhinolaryngology-Head and Neck Surgery, Aurora Medical Group, Milwaukee, WI.
authors.forename: Sammy
authors.initials: S
authors.lastname: Khalili
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.
authors.forename: James N
authors.initials: JN
authors.lastname: Palmer
authors.affiliation: Department of Neurosurgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.
authors.forename: John Y K
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Department of Radiology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.
authors.forename: Seyed Ali
authors.initials: SA
authors.lastname: Nabavizadeh
authors.affiliation: Department of Radiology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.
authors.forename: Kim O
authors.initials: KO
authors.lastname: Learned
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.
authors.forename: Nithin D
authors.initials: ND
authors.lastname: Adappa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010255:Paranasal Sinus Neoplasms / Q000378:metabolism / Q000628:therapy; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging / Q000378:metabolism*; D000072078:Positron Emission Tomography Computed Tomography; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D012189:Retrospective Studies
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Key Words; PET/CT; endoscopic skull base surgery; esthesioneuroblastoma; postoperative surveillance; sinonasal malignancy