Integrated PET/CT System for Staging and Surveillance of Skull Base Tumors

Background: The utility of pre- and postoperative whole-body integrated 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 scan 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 predicted value and 0.76 negative predicted value).

Conclusions: PET-CT provides accurate data on anatomy, tumor staging, and early disease recurrence in the skull base.