Treatment Response Evaluation in Necrotizing Otitis Externa Using 18 F-FDG-PET Imaging.
| Title: | Treatment Response Evaluation in Necrotizing Otitis Externa Using 18 F-FDG-PET Imaging. |
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| Authors: | Jansen RW; Kemp P; Department of Otolaryngology-Head and Neck Surgery.; Wiegers SE; Department of Radiology and Nuclear Medicine, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.; de Graaf P; Department of Radiology and Nuclear Medicine, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.; van Schie A; Department of Radiology and Nuclear Medicine, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.; Martens RM; Department of Radiology and Nuclear Medicine, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.; Boellaard R; Department of Radiology and Nuclear Medicine, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.; Zwezerijnen GJC; Department of Radiology and Nuclear Medicine, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.; Goderie T; Department of Otolaryngology-Head and Neck Surgery. |
| Source: | Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology [Otol Neurotol] 2025 Mar 01; Vol. 46 (3), pp. 295-302. Date of Electronic Publication: 2025 Jan 09. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 100961504 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1537-4505 (Electronic) Linking ISSN: 15317129 NLM ISO Abbreviation: Otol Neurotol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Hagerstown, MD : Lippincott Williams & Wilkins, c2001- |
| MeSH Terms: | Otitis Externa*/diagnostic imaging ; Otitis Externa*/drug therapy ; Otitis Externa*/pathology ; Otitis Externa*/therapy ; Positron Emission Tomography Computed Tomography*; Necrosis/diagnostic imaging ; Humans ; Male ; Female ; Fluorodeoxyglucose F18 ; Retrospective Studies ; Middle Aged ; Adult ; Aged ; Treatment Outcome ; Radiopharmaceuticals ; Recurrence ; Positron-Emission Tomography |
| Abstract: | Objective: This study aims to identify 18 F-FDG-PET imaging features for improving treatment response evaluation in patients with necrotizing otitis externa (NOE), aiding in the difficult differentiation between sterile inflammation and active infection.; Study Design: Retrospective cohort study.; Setting: Tertiary hospital.; Patients: Patients diagnosed with NOE between 2011 and 2022. NOE criteria included otalgia, otorrhea, granulation, and radiological features consistent with osteomyelitis.; Intervention: 18 F-FDG-PET/computed tomography (CT) parameters were derived from manually delineated regions of interest and were evaluated on both pretreatment and end-of-treatment scans.; Main Outcome Measures: Recurrent disease of NOE after end-of-treatment 18 F-FDG-PET scans.; Results: This study comprised 20 NOE patients, including 5 (25%) experiencing recurrent disease after the end-of-treatment scan. The end-of-treatment 18 F-FDG-PET parameters of maximal and peak standardized uptake value (SUVmax and SUVpeak) were significantly higher in recurrent cases ( p = 0.025 and p = 0.025, respectively). Both parameters demonstrated good discrimination ability in predicting recurrence, with optimal cutoffs yielding 100% sensitivity and 67% specificity. Other parameters, including mean SUV and total lesion glycolysis (TLG), did not yield significant results, neither did the calculated difference in uptake between end-of-treatment and pretreatment scans.; Conclusions: SUVpeak on 18 F-FDG-PET was the preferred parameter for treatment response evaluation of NOE at the end-of-treatment scan. A high residual SUVpeak may adequately detect patients at risk for recurrent disease, which may necessitate prolonged treatment, while low SUVpeak is found in patients with low risk for recurrent disease permitting safe treatment cessation.; (Copyright © 2025, Otology & Neurotology, Inc.) |
| Competing Interests: | Funding and conflict of interest disclosures: Nothing to disclose. |
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| Substance Nomenclature: | 0Z5B2CJX4D (Fluorodeoxyglucose F18); 0 (Radiopharmaceuticals) |
| Entry Date(s): | Date Created: 20250111 Date Completed: 20250430 Latest Revision: 20250521 |
| Update Code: | 20260130 |
| DOI: | 10.1097/MAO.0000000000004402 |
| PMID: | 39794893 |
| Database: | MEDLINE |
Journal Article