Fluorodeoxyglucose positron emission tomography in the evaluation of tumors of the nasopharynx, paranasal sinuses, and nasal cavity

Introduction: The purpose of this study was to review the clinical utility of 2-[¹⁸F]-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in the diagnostic evaluation of a series of patients with tumors of the nasopharynx, paranasal sinuses, and nasal cavity. Methods: The study group included 16 patients from a single institution who underwent a total of 31 FDG-PET scans for the evaluation of various histologic types of masses of the nasopharynx, nasal cavity, and paranasal sinuses for diagnosis and or surveillance. A review of the patients' medical records was performed in order to obtain all data including tumor type and location, PET scan results, CT and MRI results, treatments performed, tumor recurrence, and clinical outcome. This data was analyzed to determine the utility of FDG-PET in the identification of primary tumors and/or recurrent disease. Results: FDG-PET identified 100% of all primary tumors examined with initial diagnostic intent (n=8). In addition, 1 case of lymphoid hyperplasia was correctly identified as nonmalignant. Of 22 PET scans performed for tumor surveillance, 16 scans identified recurrent disease and 5 scans were correctly interpreted as negative. One scan showed an area of increased metabolism at the base of tongue suspicious for malignancy that later proved to be an inflammatory process (1 false positive). Conclusion: FDG-PET was an effective imaging modality in the evaluation of primary and recurrent tumors of the nasopharynx, paranasal sinuses, and nasal cavities in our series. As a functional scanning modality, FDG-PET is particularly useful in tumor surveillance where normal anatomy has been disrupted by prior surgery or radiation. Our series reaffirms the results of similar series with respect to the use of PET in these particular sub sites of the head and neck.