J Korean Soc Radiol.  2016 Jul;75(1):17-25. 10.3348/jksr.2016.75.1.17.

CT, MRI, and FDG PET/CT Findings of Sinonasal Sarcoma: Differentiation from Squamous Cell Carcinoma

• Kim JH
• Yoon DY
• Baek S
• Park MW
• Kwon KH
• Rho YS

• KMID: 2327362
• DOI: http://doi.org/10.3348/jksr.2016.75.1.17

Abstract

PURPOSE
To evaluate computed tomography (CT), magnetic resonance imaging (MRI), and 18F-fluorodeoxyglucose (FDG) positron emission tomography/CT (PET/CT) findings for the differentiation of sinonasal sarcoma from squamous cell carcinoma (SCC).
MATERIALS AND METHODS
We retrospectively reviewed CT, MRI, and FDG PET/CT results in 20 patients with pathologically proven sinonasal sarcoma (n = 7) and SCC (n = 13). Imaging characteristics of tumors, such as the shape, size, margin, MRI signal intensity, pattern of enhancement, local tumor invasion, and maximum standardized uptake value (SUVmax) were analyzed and compared between sarcoma and SCC.
RESULTS
The SUVmax of sarcomas (7.4 ± 2.1) was significantly lower than the SUVmax of the SCCs (14.3 ± 4.5) (p = 0.0013). However, no significant difference in the shape, size, margin, MRI signal intensity, pattern of enhancement, and local tumor invasion was observed between sarcoma and SCC.
CONCLUSION
Although CT and MR imaging features are nonspecific, FDG PET/CT is useful in distinguishing between sinonasal sarcoma and SCC based on the SUVmax value.

MeSH Terms

Carcinoma, Squamous Cell*
Electrons
Epithelial Cells*
Humans
Magnetic Resonance Imaging*
Paranasal Sinus Neoplasms
Positron-Emission Tomography
Positron-Emission Tomography and Computed Tomography*
Retrospective Studies
Sarcoma*

Figure

• 

  Fig. 1 A 35-year-old man with chondrosarcoma in the nasal cavity (case 7). A. Axial contrast-enhanced CT scan shows a well-defined ovoid mass with heterogeneous enhancement (arrow) in both nasal cavities and direct extension into both maxillary sinuses. Note amorphous calcifications (long arrow) within the mass. In addition, sinusitis was also seen in the left maxillary sinus. B, C. Axial T2-weighted (B) and T1-weighted (C) MRIs show a well-defined mass (arrows) with iso-intensity on T1-weighted images and hyperintensity on T2-weighted images as compared to the muscle. In addition, sinusitis was also seen in the left maxillary sinus. D. Axial contrast-enhanced T1-weighted MRI shows marked and homogeneous enhancement (arrow). E. PET/CT image in the axial plane shows moderate FDG uptake (SUVmax = 5.9) within the mass (arrow). CT = computed tomography, FDG = fluorodeoxyglucose, MRI = magnetic resonance imaging, PET = positron emission tomography, SUVmax = maximum standardized uptake value

• 

  Fig. 2 A 66-year-old man with squamous cell carcinoma in the left maxillary sinus (case 20). A. Axial contrast-enhanced CT scan shows a large mass with faint enhancement (arrow) in the left maxillary sinus and extra-sinus extension. In addition, right maxillary sinusitis and multiple nasal polyps were also observed. B, C. Axial T2-weighted (B) and T1-weighted (C) MRIs show a well-defined mass (arrows) with iso-intensity on T1-weighted images and hyperintensity on T2-weighted images as compared to the muscle. In addition, right maxillary sinusitis and multiple nasal polyps were also observed. D. Axial contrast-enhanced T1-weighted MRI shows marked and heterogeneous enhancement (arrow). E. PET/CT image in the axial plane shows marked FDG uptake (SUVmax = 17.1) within the mass (arrow). CT = computed tomography, FDG = fluorodeoxyglucose, PET = positron emission tomography, SUVmax = maximum standardized uptake value

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