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KUANetal.

TABLE XVI.6 Evidence surrounding the use of imaging to predict pedicle location.

Clinical endpoints

Study

Year LOE Study design Study groups

Conclusion

Lee et al. 684

CT is useful preoperative tool to identify site of origin and had high specificity (92.0%) but low sensitivity (59.5%) for skull base involvement Osteitic changes are common and nonspecific Sensitivity 74%, specificity 0%, predictive value for localization was 41% CT combined with MRI provides increased sensitivity (94.6%) and specificity (92.3%) for preoperatively localization of origin site for sinonasal IP Computed tomography imaging has a high PPV (95%) when determining most likely site of attachment for IP

1. Identification of pedicle

2021

3

Retrospective cohort

Patients with IP who underwent CT preoperatively for surgical planning ( n = 86) Patients with IP or cylindrical papilloma who underwent

2. Sensitivity 3. Specificity

Al Badaai et al. 766

2011

3

Retrospective cohort

1. Identification of pedicle

2. Sensitivity 3. Specificity

preoperative CT for localization of site of origin by a head and neck radiologist ( n = 34)

Fanget al. 709

1. Identification of pedicle

2016 4

Retrospective case series

Patients with IP who underwent preoperative MRI andCT for

2. Sensitivity 3. Specificity

localization of site of origin ( n = 143)

Bhallaand Wright 708

2009 4

Retrospective case series

Patients who

1. Identification of pedicle 2. PPV

underwent CT for preoperative prediction of site of attachment of IP lesion ( n = 24) hyperostotic foci on preoperative imaging (CT) for surgical planning for IP ( n = 48)

Lee et al. 711

Identification of pedicle

CT imaging revealing hyperostosis in the setting of IP was predictive of site of attachment in 49 out of 55 cases (89.1%)

2007 4

Retrospective case series

Patients with

Yousuf and Wright 714

2007 4

Retrospective case series

Patients with

Identification of pedicle

CT imaging revealing hyperostosis in the setting of IP was predictive of the site of attachment in 22 out of 25 cases (88.0%) A columnar pattern was a reliable MRI indicator of IP histology (PPV = 95.8%) and can be used to differentiate from malignant lesions

preoperative CT imaging of IP ( n = 28)

Maroldi et al. 713

1. Identification of IP 2. PPV

2004 4

Retrospective case series

Patients with sinonasal tumors and preoperative imaging (MRI) ( n = 46; n = 23with primary or recurrent IP)

Abbreviations: CT, computed tomography; IP, inverted papilloma; MRI, magnetic resonance imaging; PPV, positive predictive value.