Positron emission tomography evaluation of sinonasal inverted papilloma and related conditions: a prospective clinical study

This study aims to determine whether there is a difference between inverted papilloma (IP) and nasal polyp, and squamous cell carcinoma (SCC) with regard to fluorodeoxyglucose uptake.Between September 2007 and May 2014, positron emission tomography computed tomography (PET/CT) images of 27 patients (20 males, 7 females; mean age 53.4 years; range 18 to 74 years), with unilateral polyposis diagnosed on examination and tomographic scans of paranasal sinus were obtained. Nasal polyps in eight of the patients (group 1), IP in 10 patients (group 2), and SCC in nine patients (group 3) were found. The data were compared with Kruskal-Wallis and Mann-Whitney U tests.The mean maximum standardized uptake (SUVmax) values were found to be 2.9 in the group 1; 7.8 in the group 2, and 17.8 in the group 3. There was significant difference in the SUVmax values between the group 1 and the group 2 (p=0.016), the group 1 and the group 3 (p=0.001), and the group 2 and the group 3 (p=0.01).According to the results of this study, PET/CT scan in the patients with unilateral polyposis is invaluable to distinguish nasal polyp from IP and SCC. It is also useful to recognize the distinctions between IP and SCC. In our study of 27 patients, a SUVmax of 6 or higher ruled out the presence of nasal polyp [95% CI (5.93 to 13.39), specificity 100%] might also be clinically useful.