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This retrospective Turkish review of 92 patients aimed to determine the ability of fluorine 18-fluorodeoxyglucose (FDG) maximum standardised uptake value (SUVmax) on positron emission tomography/computerised tomography (PET/CT) to differentiate benign processes and malignant nasopharyngeal lesions. The authors retrospectively reviewed the medical records of patients who underwent FDG PET/CT for diseases other than nasopharyngeal cancer with subsequent endoscopic nasopharyngeal biopsy. They used a receiver operating characteristic (ROC) curve analysis to define the SUVmax level that reliably could differentiate between benign and malignant nasopharyngeal lesions. They concluded that a cut off SUVmax level of 6.5 resulted in 89% sensitivity and 64% specificity in terms of detecting malignant nasopharyngeal lesions. The authors therefore suggest that an SUVmax level of 6.5 or above is suspicious of malignancy and requires further investigation. This provides a useful guideline for clinicians as to when to biopsy patients with incidental increased SUVmax on FDG PET/CT.

Differentiation of benign and malignant nasopharyngeal lesions based on FDG uptake on PET/CT: comparison with pathology.
Demir B, Binnetoglu A, Gundogdu Y, Batman C.
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Sunil Sharma

Alder Hey Children's Hospital, UK.

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