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

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 (18)F-FDG PET/CT”, which is an excellent tool in detecting and staging these cancers. For certain types of tumors, other imaging tracers like (11)C-choline and (68)Ga-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 (18)F-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 (11)C-choline, and radiolabeled somatostatin analogs, including (68)Ga-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 (18)F-FDG, such as post-surgical and post-radiotherapy crusting and inflammation, may cause false-positive hypermetabolism in the absence of relapse.