, Volume 51, Issue 4, pp 265–271 | Cite as

18F-FDG PET/CT findings of sinonasal inverted papilloma with or without coexistent malignancy: comparison with MR imaging findings in eight patients

  • Tae Yeon Jeon
  • Hyung-Jin KimEmail author
  • Joon Young Choi
  • In Ho Lee
  • Sung Tae Kim
  • Pyoung Jeon
  • Keon Ha Kim
  • Hong Sik Byun
Head and Neck Radiology



Sinonasal inverted papilloma (IP) is known for high rate of associated malignancy. The purpose of this study was to identify 18F-FDG PET/CT findings of sinonasal IPs. We also tried to compare the PET/CT findings with the MR imaging findings.


We retrospectively reviewed PET/CT and MR images of eight patients with sinonasal IP with (n = 6) or without (n = 2) coexistent squamous cell carcinoma (SCC). Particular attention was paid to correlate the PET/CT findings with the MR imaging findings in terms of area distribution of standard uptake values (SUVs) and a convoluted cerebriform pattern (CCP).


In two benign IPs, the maximum SUVs measured 8.2 and 7.8, respectively (mean, 8.0). In both tumors, MR images demonstrated a diffuse CCP. In six IPs with coexistent SCC, the maximum SUVs ranged from 13.3 to 31.9 (mean ± SD, 20.2 ± 6.6). In these tumors, MR images demonstrated a diffuse CCP in two, a partial CCP in three, and no CCP in one. A wide discrepancy was noted between MR imaging and PET/CT in terms of area distribution of a CCP and SUVs.


In sinonasal lesions with MR imaging features of IP, 18F-FDG PET/CT demonstrating avid FDG uptake does not necessarily imply the presence of coexistent malignancy. In our small series, although IPs containing foci of SCC had consistently higher SUVs than IPs without SCC, the limited literature on this subject suggests that PET cannot be used reliably to make the distinction.


Positron-emission tomography/CT Magnetic resonance imaging Sinonasal neoplasm Inverted papilloma 


Conflict of interest statement

We declare that we have no conflict of interest.


  1. 1.
    Skolnik EM, Loewy A, Friedman JE (1966) Inverted papilloma of the nasal cavity. Arch Otolaryngol 84:61–67PubMedGoogle Scholar
  2. 2.
    Melroy CT, Senior BA (2006) Benign sinonasal neoplasms: a focus on inverting papilloma. Otolaryngol Clin North Am 39:601–617. doi: 10.1016/j.otc.2006.01.005 PubMedCrossRefGoogle Scholar
  3. 3.
    Hyams VJ (1971) Papillomas of the nasal cavity and paranasal sinuses. A clinicopathological study of 315 cases. Ann Otol Rhinol Laryngol 80:192–206PubMedGoogle Scholar
  4. 4.
    Lesperance MM, Esclamado RM (1995) Squamous cell carcinoma arising in inverted papilloma. Laryngoscope 105:178–183. doi: 10.1288/00005537-199502000-00013 PubMedCrossRefGoogle Scholar
  5. 5.
    Barnes L (2002) Schneiderian papillomas and nonsalivary glandular neoplasms of the head and neck. Mod Pathol 15:279–297. doi: 10.1038/modpathol.3880524 PubMedCrossRefGoogle Scholar
  6. 6.
    Lawson W, Kaufman MR, Biller HF (2003) Treatment outcomes in the management of inverted papilloma: an analysis of 160 cases. Laryngoscope 113:1548–1556. doi: 10.1097/00005537-200309000-00026 PubMedCrossRefGoogle Scholar
  7. 7.
    Roobottom CA, Jewell FM, Kabala J (1995) Primary and recurrent inverting papilloma: appearances with magnetic resonance imaging. Clin Radiol 50:472–475. doi: 10.1016/S0009-9260(05) 83163-0 PubMedCrossRefGoogle Scholar
  8. 8.
    Ojiri H, Ujita M, Tada S, Fukuda K (2000) Potentially distinctive features of sinonasal inverted papilloma on MR imaging. AJR Am J Roentgenol 175:465–468PubMedGoogle Scholar
  9. 9.
    Pasquini E, Sciarretta V, Farneti G, Modugno GC, Ceroni AR (2004) Inverted papilloma: report of 89 cases. Am J Otolaryngol 25:178–185. doi: 10.1016/j.amjoto.2004.01.004 PubMedCrossRefGoogle Scholar
  10. 10.
    Jeon TY, Kim H-J, Chung S-K et al (2008) Sinonasal inverted papilloma: value of convoluted cerebriform pattern on MR imaging. AJNR Am J Neuroradiol 29:1556–1560. doi: 10.3174/ajnr.A1128 PubMedCrossRefGoogle Scholar
  11. 11.
    Fischbein NJ, AA OS, Caputo GR et al (1998) Clinical utility of positron emission tomography with 18F-fluorodeoxyglucose in detecting residual/recurrent squamous cell carcinoma of the head and neck. AJNR Am J Neuroradiol 19:1189–1196PubMedGoogle Scholar
  12. 12.
    Goodwin WJ (1998) PET and recurrent squamous cell carcinoma of the head and neck: a surgeon’s view. AJNR Am J Neuroradiol 19:1197PubMedGoogle Scholar
  13. 13.
    Schoeder H, Yeung HW (2004) Positron emission imaging of head and neck cancer, including thyroid carcinoma. Semin Nucl Med 34:180–197. doi: 10.1053/j.semnuclmed.2004.03.004 CrossRefGoogle Scholar
  14. 14.
    Bar-Shalom R, Yefremov N, Guralnik L et al (2003) Clinical performance of PET/CT in evaluation of cancer: additional value for diagnostic imaging and patient management. J Nucl Med 44:1200–1209PubMedGoogle Scholar
  15. 15.
    Antoch G, Saoudi N, Kuehl H et al (2004) Accuracy of whole-body dual-modality fluorine-18-2-fluoro-2-deoxy-d-glucose positron emission tomography and computed tomography (FDG-PET/CT) for tumor staging in solid tumors: comparison with CT and PET. J Clin Oncol 22:4357–4368. doi: 10.1200/JCO.2004.08.120 PubMedCrossRefGoogle Scholar
  16. 16.
    Lee KW, Kuo WR, Tsai CC et al (2007) Positive positron emission tomography/computed tomography in early inverted papilloma of the maxillary sinus. J Clin Oncol 25:4848–4850. doi: 10.1200/JCO.2007.13.1540 PubMedCrossRefGoogle Scholar
  17. 17.
    Ninomiya H, Oriuchi N, Kahn N et al (2004) Diagnosis of tumor in the nasal cavity and paranasal sinuses with [11C]choline PET: comparative study with 2-[18F]fluoro-2-deoxy-d-glucose (FDG) PET. Ann Nucl Med 18:29–34. doi: 10.1007/BF02985611 PubMedCrossRefGoogle Scholar
  18. 18.
    Shojaku H, Fujisaka M, Yasumura S et al (2007) Positron emission tomography for predicting malignancy of sinonasal inverted papilloma. Clin Nucl Med 32:275–278. doi: 10.1097/ PubMedCrossRefGoogle Scholar
  19. 19.
    Barnes L, Tse LLY, Hunt JL (2005) Schneidrian papillomas. In: Barnes L, Eveson JW, Reichert P et al (eds) World Health Organization classification of tumours. Pathology and genetics of head and neck tumours. ARC, Lyon, pp 28–32Google Scholar
  20. 20.
    Myers EN, Fernau JL, Johnson JT, Tabet JC, Barnes EL (1990) Management of inverted papilloma. Laryngoscope 100:481–490PubMedGoogle Scholar
  21. 21.
    Maroldi R, Farina D, Palvarini L, Lombardi D, Tomenzoli D, Nicolai P (2004) Magnetic resonance imaging findings of inverted papilloma: differential diagnosis with malignant sinonasal tumors. Am J Rhinol 18:305–310PubMedGoogle Scholar
  22. 22.
    Lawson W, Le Benger J, Som P, Bernard PJ, Biller HF (1989) Inverted papilloma: an analysis of 87 cases. Laryngoscope 99:1117–1124. doi: 10.1288/00005537-198911000-00003 PubMedCrossRefGoogle Scholar
  23. 23.
    Lawson W, Ho BT, Shaari CM, Biller HF (1995) Inverted papilloma: a report of 112 cases. Laryngoscope 105:282–288. doi: 10.1288/00005537-199503000-00011 PubMedCrossRefGoogle Scholar
  24. 24.
    Yousem DM, Fellows DW, Kennedy DW et al (1992) Inverted papilloma: evaluation with MR imaging. Radiology 185:501–505PubMedGoogle Scholar
  25. 25.
    Nowak B, Di Martino E, Janicke S et al (1999) Diagnostic evaluation of malignant head and neck cancer by F-18-FDG PET compared to CT/MRI. Nucl Med (Stuttg) 38:312–318Google Scholar
  26. 26.
    Schoder H, Yeung HW, Gonen M, Kraus D, Larson SM (2004) Head and neck cancer: clinical usefulness and accuracy of PET/CT image fusion. Radiology 231:65–72. doi: 10.1148/radiol.2311030271 PubMedCrossRefGoogle Scholar
  27. 27.
    Lin FY, Genden EM, Lawson WL, Som P, Kostakoglu L (2009) High uptake in Schneiderian papillomas of the maxillary sinus on positron-emission tomography using fluorodeoxyglucose. AJNR Am J Neuroradiol 30:428–430PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Tae Yeon Jeon
    • 1
  • Hyung-Jin Kim
    • 1
    Email author
  • Joon Young Choi
    • 2
  • In Ho Lee
    • 1
  • Sung Tae Kim
    • 1
  • Pyoung Jeon
    • 1
  • Keon Ha Kim
    • 1
  • Hong Sik Byun
    • 1
  1. 1.Department of Radiology, Samsung Medical CenterSungkyunkwan University School of MedicineKangnam-KuSouth Korea
  2. 2.Department of Nuclear Medicine, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea

Personalised recommendations