Vevek Parikh, Presenter: Nothing to Disclose

John Edward Buterbaugh MD, Abstract Co-Author: Nothing to Disclose

Matthew Covington MD, Abstract Co-Author: Nothing to Disclose

To determine whether there is any evidence of chronic sinus inflammation by correlating FDG uptake with CT findings of chronic sinus disease. 

An IRB-approved retrospective evaluation of 172 consecutive patients receiving whole body positron-emission tomography/computed tomography (PET/CT) examinations from June 2013 through December 2013 was conducted to determine whether there is any evidence of correlation between sinus disease seen on CT and inflammation seen on PET. The images were reviewed using MIM viewing software (MIM Software Inc., Cleveland, OH). The CT exam portions of the PET/CT exams were evaluated for evidence of disease within the paranasal sinuses, specifically in relation to the maxillary, ethmoid, sphenoid and frontal sinuses. Evidence of sinus disease included mucosal thickening, fluid within the sinus, mucosal polyps or retention cysts, mucocele, or any other cause of non-congenital sinus opacification. Sinus disease was graded using the Lund-Mackay staging system. CT findings of chronic sinus disease were then correlated with FDG uptake in the involved sinuses, and maximum standard uptake values (SUV) were recorded at both the region of sinus disease and in the surrounding uninvolved portion of the sinus adjacent to the focus of sinus disease.

Out of 172 patients examined between June and December 2013 undergoing PET/CT examinations, 53 patients were found to have CT evidence of sinus disease. The average FDG activity of the most avid sinus among patients demonstrating CT evidence of sinus disease was an SUV of 1.57. However, when compared to average background activity in the immediately surrounding sinuses, the mean increase in SUV over background of involved sinuses was 0.27. Correlation between SUV max values of the involved sinus and Lund-Mackay staging system scores yielded a Pearson correlation coefficient r = 0.31, while correlation between SUV sinus over background differences and Lund-Mackay staging system scores yielded an r = 0.27. 

There is no correlation between classically described CT findings of chronic sinusitis and inflammation seen on PET/CT. The classically described CT findings of chronic sinusitis may not be a good indicator of chronic inflammation. 

Incidental traditional CT findings of chronic sinusitis may not be indicative of chronic inflammation within the sinuses.  

Parikh, V, Buterbaugh, J, Covington, M, A Retrospective Study to Evaluate the Relationship of CT Findings of Chronic Rhinosinusitis to FDG Uptake on PET/CT.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14015559.html