Integrated PET/CT system for staging and surveillance of skull base tumors

BACKGROUND: The utility of preoperative and postoperative whole body integrated positron emission tomography-computed tomography (PET-CT) scanning for staging and follow-up in patients with skull base tumors is undetermined. METHODS: We prospectively evaluated PET-CT findings in 47 patients using 57 scans. Most (35/47, 75%) had anterior skull base tumors and the majority (74%) had advanced-stage (III-IV) disease. RESULTS: The scans showed high sensitivity for detection of various types of malignant tumors and provided 39 items of additional information, changing the clinical staging and management of 11 patients (23%). Recurrence of primary tumors was detected in 8 patients, positive regional (neck) metastases in 3, and distant metastases in 3. The positive uptake was due to osteoradionecrosis in 2 other patients. The sensitivity of PET-CT was 0.77 and the specificity was 0.81 (0.83 positive predictive value and 0.76 negative predictive value). CONCLUSIONS: PET-CT provides accurate data on anatomy, tumor staging, and early disease recurrence in the skull base.