J Neurol Surg Rep 2016; 77(01): e39-e45
DOI: 10.1055/s-0035-1570387
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Positive and Negative Predictive Value of PET-CT in Skull Base Lesions: Case Series and Systematic Literature Review

John Peyton Hines
1  Department of Otolaryngology–Head and Neck Surgery, Mayo Clinic, Phoenix, Arizona, United States
,
Brittany E. Howard
1  Department of Otolaryngology–Head and Neck Surgery, Mayo Clinic, Phoenix, Arizona, United States
,
Joseph M. Hoxworth
2  Department of Radiology, Mayo Clinic, Phoenix, Arizona, United States
,
Devyani Lal
1  Department of Otolaryngology–Head and Neck Surgery, Mayo Clinic, Phoenix, Arizona, United States
› Author Affiliations
Further Information

Publication History

07 June 2015

17 November 2015

Publication Date:
01 March 2016 (online)

Abstract

Objectives To study positive (PPV) and negative predictive value (NPV) of positron emission tomography with computed tomography (PET-CT) scans in determining malignancy in skull base lesions and perform a systematic literature review for optimal PET-CT interpretation.

Design Retrospective case series and systematic literature review of the current English literature.

Setting Tertiary referral academic medical center.

Participants All patients with skull base lesions that underwent PET-CT and tissue biopsy from 2010 to 2013.

Main Outcome Measures PPV and NPV of radiologist's report and standardized uptake value (SUV) cutoff of 2.5 and 3, biopsy with pathologic interpretation, clinical follow-up.

Results A total of 31 PET-CT scans of 16 patients were studied; 10 PET-CT were performed upfront for diagnostic purposes and 21 were post-treatment surveillance scans. The PPV of radiologist's interpretation, SUV cutoff of 2.5, and SUV cutoff of 3.0 was 80%, 60%, and 68.4%, with a NPV of 100%, 83.3%, and 75%, respectively. Literature search yielded 500 abstracts; 7 studies met inclusion criteria for detailed review. No consensus or guidelines for optimal SUV cutoff value was found.

Conclusions PET-CT based on SUV cutoff criteria alone has high NPV but low PPV in determining malignancy in skull base lesions. Interpretation by a radiologist experienced in nuclear medicine and neuroradiology, synthesizing clinical, SUV, and radiologic data are of superior value.

Notes

EBM Level: 3


This article was presented at the 24th Annual North American Skull Base Society Meeting, February 2014, San Diego, California, United States.