Pattern and prevalence of sinus disease as detected with FDG PET/CT

2712 Objectives Each year approximately 37 million Americans suffer from sinus related diseases. Cancer patients are at an increased risk of infection secondary to acute sinus disease and their immunocompromised state. Due to the sinus???s close proximity to various structures, the infection should be monitored and treated aggressively to prevent spread, especially to the brain. The objective of this study is to determine the pattern and prevalence of sinus disease on CT and sinusitis on PET in cancer patients who have undergone PET/CT. Methods PET/CT reports from 1,438 patients from July 2014 to August 2015 were retrospectively reviewed for the presence of sinus disease and/or sinusitis. Patients who were reported to have abnormal CT findings in the sinus area were categorized as having sinus disease and patients who exhibited increased FDG uptake in a sinus region were considered to have sinusitis. Results Of the 1,438 cases, 127 (8.8%) demonstrated sinus disease; 91 male (71.7%) and 36 female (28.3%). Of the 127, 26 (20.5%) demonstrated FDG-avid sinusitis and the remaining 101 (79.5%) demonstrated CT only sinus disease. Of the 26 with sinusitis, SUV max values ranged from 0.7-7.8 (mean 3.22). In addition, 78 of the 127 (61.4%) had undergone either chemotherapy or radiotherapy treatment and the remaining 49 presented at baseline. Conclusions Incidental sinus disease is not uncommon among cancer patients imaged with PET/CT and occurs in approximately 9% of cases. While sinus disease may not be a major concern, sinusitis is and should be monitored and/or treated to prevent the disease from progressing and/or spreading to surrounding structures. In cancer patients with sinus disease, PET is better than CT in the diagnosis of sinusitis.