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Table 8 PET/CT in surveillance of IP malignant transformation summary

From: Clinical evidence based review and systematic scientific review in the identification of malignant transformation of inverted papilloma

Study authorsYearStudy designLevel of evidenceStudy groupsInterventionOutcomeConclusion
Jeon et al. [35]2009Diagnostic studyB8 IP patients, 6 of them with IP associated SCC.SUVs of PET/CT images and CCP of MR images are reviewed and compared. SCC are confirmed by histologic exam.In PET/CT study, IP with SCC has consistently higher SUVs than IPs without SCC; however this test has low specificity. MRI findings showed wide discrepancy in terms of CCP distribution. Aggressive bone destruction was found in most SCC patients.PET/CT cannot be used reliably to predict malignancy yet due to limited data.
Focal loss of CCP on MR might not be additional sign of malignancy.
Allegra et al. [38]2012Diagnostic studyB12 cases (7 IP)18 FDG - PET/CT of IP patients were analyzed and compared with histological results.For IP patients the SUVmax value is larger than for non IP patients.Lesions with a negative or diffuse 18FDG uptake with SUVmax less than 3 should be considered negative for IP.
Shojaku et al. [85]2007Observational studyC5 IP patients, 2 of them have IP associated SCCFDG PET was performed on IP patients and SUVmax was analyzed.High FDG uptake (SUVmax) was observed in all patients, with a higher SUVmax in SCC patients.The SUVmax of IP can warn the physician of the probability of an associated malignancy.
Yilmaz et al. [37]2015Observational studyC8 nasal polyps vs 10 IP vs 9 SCCPET CT of 27 patients were analyzed.The mean SUVmax was found to be high in the IP group, and highest in the SCC group.High SUVmax can be used to rule out nasal polyp. The SCC group had a higher SUVmax.
Zhang et al. [36]2015Case reportD1 IP patientSIP with co-existent malignancy and cervical metastasis was reviewed.PET failed to identify the primary malignancy site because there was no SUV increase in SCC.FDG PET/CT may be not a reliable predictor of malignancy in SIP.
Kim et al. [86]2017Case reportD1 IP patientPatient had two operations and 2 sequential PET CT scans.N/AThe SUV of IP could vary over time in PET CT. PET CT is not an ideal tool to distinguish IP from other inflammatory polyps or cancer.