PET/CT in the assessment of previously treated skull base malignancies

Abstract

PET/CT is a highly sensitive test for malignant disease. The mucosal lining of the reconstructed skull base is a common source for inflammatory pathologies that may lead to false-positive PET/CT. Defining SUV thresholds for malignancy may improve specificity.

Retracted:18FDG-PET/CT computer-assisted biopsies for suspected persistent or recurrent malignant skull base disease

“…Following clinical routine, all PET/CT examinations were reviewed and reported by two board-certified nuclear medicine physicians with 6 and 11 years of experience in oncologic PET and PET/CT imaging. Visual interpretation of images was the preferred method in our institution, and similar to other institutional study protocols, standard uptake values (SUV) were not routinely measured 8,9 .…”

What is the appropriate timing for endoscopic and radiographic surveillance following treatment for sinonasal malignancies?

“…For Harvey et al, PET/CT scans were obtained at a minimum of 3 months after treatment, but specific timelines were not provided. Gil et al acquired the majority of their PET/CT scans (>80%) 6 months after treatment …”

“…1 In their retrospective series, Harvey et al demonstrated that PET/CT can have excellent sensitivity and negative predict values (100%), but its functionality is hindered by poor specificity (40%) and PPV (53.8%) in the early postoperative period. 2 This limitation exists due to the inability of PET/CT to distinguish between tumor recurrence and inflammatory change (i.e., from surgery and/or radiation therapy), reducing its utility in the early surveillance setting. Gil et al also examined the role of PET/CT imaging for surveillance and reported specificity and PPV of 85% and 67%, respectively.…”

Utility of first positron emission tomography‐computed tomography scan as a prognostic tool following treatment of sinonasal and skull base malignancies

“…[4][5][6][7][8][9][10][11] An important advantage of PET/CT is that a whole-body scan allows for the detection of distant metastases and unexpected secondary cancers. [19][20][21][22][23][24][25][26] The purpose of this study was to assess the predictive value of the first posttreatment PET/CT scan with respect to overall survival (OS) in patients with malignancies of the paranasal sinuses and skull base. 12 Although PET/CT is now routinely used for HNSCC pretreatment and posttreatment evaluations, the clinical utility of the first posttreatment PET/CT scan for predicting tumor recurrence and survival of HNSCC had been evaluated in only few publications, and mostly in human papilloma virus-related tumors.…”