OBJECTIVES: Esthesioneuroblastoma (ENB) is a rare neoplasm arising from the olfactory epithelium of the upper nasal cavity. It exhibits varied clinical behavior with the potential for locoregional recurrence and metastasis. The utility of PET/CT in the evaluation, staging, and follow-up of patients with ENB has not been well characterized, nor has the relationship between PET/CT findings and histologic grade. This study aims to evaluate the potential clinical utility of PET/CT in predicting the tumor's histologic grade. Study design: Retrospective chart review Methods: Seven patients treated for ENB who also had a PET/CT scan were included in the study. All patients had PET/CT scans 1-6 weeks before surgery, and lesions were assigned a peak SUV (standardized uptake value) that was standardized to the liver uptake. Pathology specimens were categorized into grades I-IV according to Hyams histologic grading criteria. The ratio of the lesion to liver uptake was then plotted against the pathological grade of the surgical specimen. Results: Six out of seven patients had direct correlation between the degree of lesion uptake on PET/CT and Hyams histologic grade. Conclusions: This study correlates histologic grade of ENB with FDG avidity on PET/CT. Recent data in the literature notes that the Hyams staging system may be an important factor in determining prognosis for tumor recurrence and survival. Although a small series, our study suggests that PET/CT may be utilized to predict the tumor's histologic grade. Lesion uptake on PET/CT may be utilized as a predictor of outcome and the need for post-surgical adjunctive treatment.
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