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Figure 30. 56-year-old female with metastatic ENB. (A) FDG PET MIP demonstrating multiple metastatic lymph nodes and osseous
lesions; (B) DOTATATE PET MIP obtained 1 month later revealing a much greater extent of metastatic disease, including numerous
osseous and intracranial sites not appreciated on FDG PET. The underlying CT appearances were grossly similar, excluding the
possibility that these differences were due to disease progression. ENB: Esthesioneuroblastoma; MIP: maximum intensity projection;
CT: computed tomography.

CONCLUSION
The imaging features of sinonasal malignancies, combined with the use of advanced staging protocols,
represent a significant step toward improving diagnostic accuracy and treatment planning. The
development of advanced imaging techniques, such as FDG PET/CT and DOTATATE PET/CT, heralds a
new era of enhanced diagnostic precision and a more detailed understanding of tumor behavior.
Nevertheless, the rarity and heterogeneity of these tumors continue to pose challenges. These imaging
modalities hold great potential for precise tumor mapping, tissue characterization, evaluation of treatment
response, and monitoring for recurrence. Together with histopathological analysis and clinical assessment,
they offer the prospect of a more comprehensive understanding of sinonasal malignancies and the
development of more effective treatment strategies.

DECLARATIONS
Authors’ contributions
Introduction, conclusion, Section “Overview of Sinonasal Tract Tumors”; initial submission: Singh V
Section “Systemic Staging and Surveillance Utilizing FDG PET/CT and DOTATATE PET/CT”: Khalaf A
Section “Overview of Sinonasal Tract Tumors”: Nguyen GK
Section “Key Anatomy of the Skull Base and Sinuses”: Fagan R
Review of the manuscript with edits regarding surgical considerations: Su SY
Review of the overall manuscript with edits: Learned K
Section “CT and MR Approach to Sinonasal Tumors; revisions after submission”: Hsieh KJ

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.