Sensitivity and specificity of the radiological diagnosis of inverted papilloma in the paranasal sinus area: a systematic review

Background:

Inverted papilloma (IP) is an epithelial mucosal tumor of the nasal and paranasal sinuses (NPS), which recurs in up to 70% of cases after surgical treatment and degenerates in up to 15% malignant. Thus, there is a need to improve preoperative diagnosis, clinical follow-up and in case of recurrence for surgical revision.

Objective:

Systematic literature review to assess sensitivity and specificity of diagnostic imaging of IP as well as the IP's origin with regard to targeted surgical therapy.

Methods:

Systematic analysis of PubMed-listed original papers published between January 2000 and September 2018 with the following inclusion criteria: CT, PET-CT and MRI diagnostics of IP in the NPS in English or German language.

Results:

19 publications could be identified. CT diagnosis is sensitive to pathological changes in the paranasal sinuses (54.6% – 98.33%), but with low specificity (0% – 69.2%) for IP. Radiological signs such as hyperostosis or osteitis often correlated with the origin of the IP but did not represent a particularly sensitive marker.

Conclusion:

The benefit of CT diagnostics in diagnosing an IP is still limited. The low specificity does not allow the delineation of the IP against changes that also occur in other diseases such as chronic rhinosinusitis. The combination of CT and MRI can simplify treatment planning, but is rarely feasible in everyday clinical practice for economic reasons.

Publication History

Publication Date:
23 April 2019 (online)