Performance of whole-body 18 F-FDG PET/CT as a posttreatment surveillance tool for sinonasal malignancies

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

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