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

✍ Scribed by Richard J. Harvey; Geoff Pitzer; Daniel B. Nissman; Luke Buchmann; Zoran Rumboldt; Terry Day; Rodney J. Schlosser

• Publisher: John Wiley and Sons
• Year: 2009
• Tongue: English
• Weight: 318 KB
• Volume: 32
• Category: Article
• ISSN: 1043-3074
• DOI: 10.1002/hed.21147

✦ Synopsis

Abstract

Background

Altered anatomy, radiotherapy, hardware, and reconstructive materials distort the posttreatment ventral skull base. The diagnostic characteristics of positron emission tomography/CT (PET/CT) studies in those with suspected recurrent malignancy were assessed.

Methods

A retrospective review was undertaken of patients with head and neck cancer who had PET/CT for ventral skull base disease.

Results

Thirty‐four PET/CTs were performed for suspected recurrent malignancy in the skull base (mean age, 59.6 ± 10.7 years; female 38%). The group comprised mainly minor salivary (35.3%), squamous (32.3%), and neuroectodermal (23.6%) tumors. Mean clinical follow‐up after PET/CT was 256 ± 173 days. Sensitivity was 100% but specificity was 40%. Standard uptake values (SUVs) for true positives were higher than for those without disease (p = .03).

Conclusions

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. © 2009 Wiley Periodicals, Inc. Head Neck, 2010