PET/CT Imaging in Treatment Planning and Surveillance of Sinonasal Neoplasms

Sep 24, 2026

Uploaded by Sarah

Sinonasal cancers are uncommon malignancies with an overall unfavorable prognosis and frequent late-stage presentation. Their high recurrence rate necessitates close imaging surveillance and the use of functional imaging. Whole-body 18F-FDG PET/CT offers high sensitivity for diagnosis and can act as a “metabolic biopsy,” although histological confirmation is often required. Radiotracers such as 11C-choline and 68Ga-DOTATATE/DOTATOC support treatment planning and monitoring, while false positives can occur due to post-surgical and post-radiotherapy inflammation.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages34

Reading Time1 h 26 min

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Introduction

Role of imaging and surveillance in sinonasal malignancies

Value of PET/CT in staging, treatment planning, and response assessment

cancers Review PET/CT Imaging in Treatment Planning and Surveillance of Sinonasal Neoplasms Sinan Akay 1, Janet H. Pollard 1, Assim Saad Eddin 1, Aiah Alatoum 1, Sedat Kandemirli 1, Ali Gholamrezanezhad 2, Yusuf Menda 1, Michael M. Graham 1 and Ahmad Shariftabrizi 1, * Citation: Akay, S.; Pollard, J.H.; Saad Eddin, A.; Alatoum, A.; Kandemirli, S.; Gholamrezanezhad, A.; Menda, Y.; Graham, M.M.; Shariftabrizi, A. PET/CT Imaging in Treatment Planning and Surveillance of Sinonasal Neoplasms. Cancers 2023, 15, 3759. [https://doi.org/](https://doi.org/)[ ](https://doi.org/)[10.3390/cancers15153759](10.3390/cancers15153759) Academic Editor: Sam Payabvash Received: 27 June 2023 Revised: 20 July 2023 Accepted: 21 July 2023 Published: 25 July 2023 Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) . 1 Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA 2 Department of Radiology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA 90030, USA * Correspondence: [ashariftabrizi@healthcare.uiowa.edu](ashariftabrizi@healthcare.uiowa.edu); Tel.: +1-857-526-4145; Fax: +1-319-339-7123 Simple Summary: Sinonasal cancers are rare types of cancer that are often detected at a late stage, making them difﬁcult to treat. To monitor these cancers closely, advanced imaging techniques are used. One such technique is called “Whole-body 18F-FDG PET/CT”, which is an excellent tool in detecting and staging these cancers. For certain types of tumors, other imaging tracers like 11C-choline and 68Ga-DOTATATE/DOTATOC are helpful for planning treatment and monitoring progress. In this review, we talk about how PET/CT can aid in the diagnosing, determining the extent of the disease, treatment planning, and evaluating the treatment response for different types of sinonasal tumors. The review also discusses some newer radiotracers used for PET scanning, that are proving useful in diagnosing and staging sinonasal cancers. Abstract: Sinonasal cancers are uncommon malignancies with a generally unfavorable prognosis, often presenting at an advanced stage. Their high rate of recurrence supports close imaging surveillance and the utilization of functional imaging techniques. Whole-body 18F-FDG PET/CT has very high sensitivity for the diagnosis of sinonasal malignancies and can also be used as a “metabolic biopsy” in the characterization of some of the more common subgroups of these tumors, though due to overlap in uptake, histological conﬁrmation is still needed. For certain tumor types, radiotracers, such as 11C-choline, and radiolabeled somatostatin analogs, including 68Ga-DOTATATE/DOTATOC, have proven useful in treatment planning and surveillance. Although serial scans for posttreatment surveillance allow the detection of subclinical lesions, the optimal schedule and efﬁcacy in terms of survival are yet to be determined. Pitfalls of 18F-FDG, such as post-surgical and post-radiotherapy crusting and inﬂammation, may cause false-positive hypermetabolism in the absence of relapse. Keywords: sinonasal malignancy; PET/CT; FDG; somatostatin analogs 1. Introduction Sinonasal malignancies are rare diseases, accounting for 3% to 5% of all head and neck malignant neoplasms [1] . They contain several histological subtypes with different clinical behaviors. Although the stage at presentation is highly predictive of survival, none of the existing staging systems are ideal. The fact that local, regional, or distant recurrences can be seen despite maximum treatment further increases the importance of accurate staging and close imaging follow-up

FAQs

Why is close imaging surveillance important for sinonasal cancers?

Sinonasal cancers are often detected at a late stage and have a high recurrence rate, so close imaging surveillance helps detect disease activity and monitor response.

What is the main PET/CT tracer discussed for sinonasal malignancies?

The review highlights 18F-FDG as a “workhorse” tracer that assesses glucose metabolism, supporting diagnosis and staging.

Which other PET radiotracers may help in treatment planning and surveillance?

For certain tumor types, radiotracers such as 11C-choline and radiolabeled somatostatin analogs (including 68Ga-DOTATATE/DOTATOC) can be useful for planning treatment and monitoring progress.

Sep 24, 2026

Uploaded by Sarah