Endoscopy versus imaging: Analysis of surveillance methods in sinonasal malignancy

Head Neck. 2016 Aug;38(8):1229-33. doi: 10.1002/hed.24413. Epub 2016 May 3.

Abstract

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.

Keywords: endoscopy; malignancy; recurrence; sinonasal; surveillance.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Diagnostic Imaging / statistics & numerical data*
  • Endoscopy / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Monitoring, Physiologic / methods
  • Neoplasm Recurrence, Local / diagnosis*
  • Neoplasm Recurrence, Local / epidemiology
  • Nose Neoplasms / parasitology
  • Nose Neoplasms / therapy
  • Paranasal Sinus Neoplasms / pathology
  • Paranasal Sinus Neoplasms / therapy*
  • Positron Emission Tomography Computed Tomography / methods
  • Retrospective Studies
  • Sensitivity and Specificity
  • Time Factors
  • Tomography, X-Ray Computed / methods
  • Young Adult