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Endoscopy versus imaging: Analysis of surveillance methods in sinonasal malignancy
Author(s) -
Khalili Sammy,
Worrall Douglas M.,
Brooks Steve,
Morris Shane M.,
Farquhar Douglas,
Newman Jason G.,
Learned Kim O.,
Ahn Peter H.,
Craig John,
Kennedy David W.,
O'Malley Bert W.,
Palmer James N.,
Adappa Nithin D.
Publication year - 2016
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24413
Subject(s) - medicine , endoscopy , radiology , positron emission tomography , predictive value , malignancy , retrospective cohort study , nuclear medicine , pathology
Background The purpose of this study was to assess the utility of imaging and endoscopy in posttreatment surveillance of sinonasal malignancies. Methods We conducted a retrospective analysis of primary sinonasal malignancies diagnosed between 2000 and 2014. Posttreatment surveillance included nasal endoscopy and imaging (MRI, CT, and positron emission tomography [PET]/CT). Positive predictive value (PPV), negative predictive value (NPV), specificity, and sensitivity were calculated for each modality and compared. Results One hundred nine sinonasal malignancies were identified with 30 recurrences. Endoscopy showed a sensitivity and specificity of 24% and 89%, respectively, whereas imaging was 76% and 90%, respectively. Identifying suspicious symptoms significantly improved the PPV of both endoscopy and imaging. MRI demonstrates the highest PPV when compared with other imaging modalities. Conclusion Both modalities are necessary in posttreatment surveillance. MRI shows the highest PPV, whereas endoscopy trends toward a higher specificity. PET/CT scans have a high false‐positive rate and should be reserved for tumors with a high propensity for distant metastases. © 2016 Wiley Periodicals, Inc. Head Neck 38:1229–1233, 2016