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Endoscopy versus imaging: Analysis of surveillance methods in sinonasal malignancy
Sammy Khalili1, Douglas M Worrall1, Steve Brooks1
1Division of Rhinology, Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
Head & Neck
|May 5, 2016
Summary
Posttreatment surveillance for sinonasal malignancies requires both imaging and endoscopy. While Magnetic Resonance Imaging (MRI) offers the highest positive predictive value, endoscopy shows better specificity for detecting cancer recurrence.
Area of Science:
- Otolaryngology
- Oncology
- Radiology
Background:
- Sinonasal malignancies require diligent posttreatment surveillance.
- Assessing the effectiveness of diagnostic tools is crucial for patient management.
Purpose of the Study:
- To evaluate the diagnostic utility of imaging and endoscopy in monitoring patients after treatment for sinonasal cancers.
- To compare the accuracy of different surveillance methods.
Main Methods:
- Retrospective analysis of 109 primary sinonasal malignancies diagnosed between 2000 and 2014.
- Comparison of nasal endoscopy and various imaging techniques (MRI, CT, PET/CT) for recurrence detection.
- Calculation and comparison of diagnostic values: positive predictive value (PPV), negative predictive value (NPV), sensitivity, and specificity.
Main Results:
- Imaging demonstrated higher sensitivity (76%) and specificity (90%) compared to endoscopy (24% sensitivity, 89% specificity).
- Magnetic Resonance Imaging (MRI) exhibited the highest positive predictive value (PPV) among imaging modalities.
- The presence of suspicious symptoms significantly improved the PPV for both endoscopy and imaging.
Conclusions:
- Both imaging and endoscopy are essential components of posttreatment surveillance for sinonasal malignancies.
- MRI is the preferred imaging modality due to its high PPV.
- Positron Emission Tomography/Computed Tomography (PET/CT) should be used judiciously due to a high false-positive rate, reserved for specific high-risk cases.
