Incidental FDG-Avid Focuses in Palatine Tonsils on PET/CT.
case_series · Level IV
Where this comes from
- Record sourced from PubMed, PMID 35226376.
- Also identified by DOI 10.1002/lary.30081 and PMC identifier 9790499.
- Licence recorded as CC BY-NC-ND.
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Abstract
The management of incidental findings of FDG-avid tonsils on PET/CT (IFT) is unclear. We aimed to explore the prevalence of malignancy in IFT, identify risk factors for malignancy, and calculate optimal cutoffs of maximum standardized uptake values (SUV<sub>max</sub> ) to discriminate between benign and malignant lesions. All patients who were tonsillectomized at our institution because of IFT from October 2011 to December 2020 were included. Patients undergoing PET/CT due to suspected tonsillar disease or cancer of unknown primary were excluded. In total, 77 patients were included, of which 11 (14%) of them had IFT malignancy. Dysphagia (p = 0.019) and alcohol abuse (p = 0.035) were associated with malignancy. Absolute SUV<sub>max</sub> cutoff (≥9: sensitivity 100%; specificity 53%) was superior to SUV<sub>max</sub> side-to-side ratio (≥1.5: sensitivity 64%; specificity 70%) to discriminate between benign and malignant lesions. We recommend tonsillectomy for patients with IFT displaying SUV<sub>max</sub> ≥ 9.0, ratio ≥ 1.5, or symptoms or findings suggesting malignancy. 3 Laryngoscope, 132:2370-2378, 2022.
Medical subject headings
- Positron Emission Tomography Computed Tomography
- Tonsillectomy