Abstract
Objective
18F-2-deoxy-2-fluoro-d-glucose positron emission tomography (FDG-PET) is a promising screening modality targeting whole body. However, the validity of PET cancer screening remains to be assessed. Even the screening accuracy for whole-body screening using FDG-PET has not been evaluated. In this study, we investigated the screening accuracy of PET cancer screening.
Methods
A total of 2911 asymptomatic participants (1629 men and 1282 women, mean age 59.79 years) underwent both FDG-PET and other thorough examinations for multiple organs (gastrofiberscopy, total colonofiberscopy or barium enema, low-dose thin section computed tomography and sputum cytology, abdominal ultrasonography, an assay of prostate-specific antigen, mammography, mammary ultrasonography, Pap smear for the uterine cervix, and magnetic resonance imaging for the endometrium and ovaries) between February 2004 and January 2005, and followed sufficiently. The detection rate, sensitivity, specificity, and positive predictive value of FDG-PET were calculated using cancer data obtained from all examinations along with a 1 year follow-up.
Results
From among 2911 participants FDG-PET found 28 cancers, 129 cancers were PET negative. PET-positive cancers comprised seven colorectal cancers, four lung cancers, four thyroid cancers, three breast cancers, two gastric cancers, two prostate cancers, two small intestinal sarcomas (gastrointestinal stromal tumors), one malignant lymphoma, one head and neck malignancy (nasopharyngeal carcinoid tumor), one thymoma, and one hepatocellular carcinoma. PET-negative cancers included 22 gastric cancers and 20 prostate cancers that were essentially difficult to detect using FDG-PET. The overall detection rate, sensitivity, specificity, and positive predictive value were estimated to be 0.96%, 17.83%, 95.15%, and 11.20%, respectively.
Conclusions
FDG-PET can detect a variety of cancers at an early stage as part of a whole-body screening modality. The detection rate of PET cancer screening was higher than that of other screening modalities, which had already shown evidence of efficacy. However, the sensitivity of PET cancer screening was lower than that of other thorough examinations performed at our institute. FDG-PET has some limitations, and cancer screening using only FDG-PET is likely to miss some cancers.
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References
Hamashima H, Sobue T, Muramatsu Y, Saito H, Moriyama N, Kakizoe T. Comparison of observed and expected numbers of detected cancers in the research center for cancer prevention and screening program. Jpn J Clin Oncol 2006;36:301–308.
Rigo P, Paulus P, Kaschten BJ, Hustinx R, Bury T, Jerusalem G, et al. Oncological application of positron emission tomography with fluorine-18 fluorodeoxyglucose. Eur J Nucl Med 1996;23:1641–1674.
Adler LP, Blair HF, Makley JT, Williams RP, Joyce MJ, Leisure G, et al. Noninvasive grading of muscloskeletal tumors using PET. J Nucl Med 1991;32:1508–1512.
Price P, Jones T. Can positron emission tomography (PET) be used to detect subclinical response to cancer therapy? Eur J Cancer 1995;31A:1924–1927.
Okada J, Oonishi H, Yoshikawa K, Itami J, Uno K, Imaseki K, et al. FDG-PET for predicting the prognosis of malignant lymphoma. Ann Nucl Med 1994;8:187–191.
Nakata B, Chung YS, Nishimura S, Nishihara T, Sakurai Y, Sawada T, et al. 18F-fluorodeoxyglucose positron emission tomography and the prognosis of patients with pancreatic adenocarcinoma. Cancer 1997;79:695–699.
Oshida M, Uno K, Suzuki M, Nagashima T, Hashimoto H, Yagata H, et al. Predicting the prognosis of breast carcinoma patients with positron emission tomography using 2-deoxy-2-fluoro[18F]-d-glucose. Cancer 1998;82:2227–2234.
Sobin LH, Wittekind CH, editors. TNM classification of malignant tumors. 5th ed. New York: Wiley; 1997.
Yasuda S, Ide M, Fujii H, Nakahara T, Mochizuki Y, Tkahashi W, et al. Application of positron emission tnomography imaging to cancer screening. Br J Cancer 2000;83:1607–1611.
Halter G, Storck M, Guhlmann A, Frank J, Grosse S, Liewald F. FDG positron emission tomography in the diagnosis of peripheral focal lesions. Thorac Cardiovasc Surg 2000;48:97–101.
Cook GJ, Fogelman I, Maisey MN. Normal physiological and benign pathological variants of 18-fluoro-2-deoxyglucose positron-emission tomography scanning: potential for error in interpretation. Semin Nucl Med 1996;26:308–314.
Moran JK, Lee HB, Blaufox MD. Optimization of urinary excretion during PET imaging. J Nucl Med 1999;40:1352–1357.
Higashi K, Ueda Y, Seki H, Yuasa K, Oguchi M, Noguchi T, et al. Fluorine-18-FDG PET imaging is negative in bronchioloalveolar lung carcinoma. J Nucl Med 1998;39:1016–1020.
Stahl A, Ott K, Weber WA, Fink U, Siewert JR, Schwaiger M. Correlation of FDG uptake in gastric carcinomas with endoscopic and histopathological findings (abstract). J Nucl Med 2001;42Suppl:78P.
Gould MK, Maclean CC, Kuschner WG, Rydzak CE, Owens DK. Accuracy of positron emission tomography for diagnosis of pulmonary nodules and mass lesions: a meta-analysis. JAMA 2001;285:914–924.
Miyakita H, Tokunaga M, Onda H, Usui Y, Kinoshita H, Kawamura N, et al. Significance of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) for detection of renal cell carcinoma and immunohistochemical glucose transporter 1 (GLUT-1) expression in the cancer. Int J Urol 2002;9:15–18.
Torizuka T, Tamaki N, Inokuma T, Nagata Y, Sasayama S, Yonekura Y, et al. In vivo assessment of glucose metabolism in hepatocellular carcinoma with FDG-PET. J Nucl Med 1995;36:1811–1817.
Kang KW, Kim SK, Kang HS, Lee ES, Sim JS, Lee IG, et al. Prevalence and risk of cancer of focal thyroid incidentaloma identified by 18F-fluolrodeoxyglucose positron emission tomography for metastasis evaluation and cancer screening in healthy subjects. J Clin Endocrinol Metab 2003;88:4100–4104.
Ono K, Ochiai R, Yoshida T, Kitagawa M, Omagari J, Kobayashi H, et al. The detection rate and tumor clinical/pathological stages of whole body FDG-PET cancer screening. Ann Nucl Med 2007;21:65–72.
Hisamichi S, Tsuji I, Tsubono Y, Nishino Z. The effectiveness of cancer screening in Japan (in Japanese). Sendai: Tohoku University Press; 2001.
Yasuda S, Ide M. PET and cancer screening. Ann Nucl Med 2005;19:167–177.
Minamimoto R, Senda M, Uno K, Jinnouchi S, Iinuma T, Ito K, et al. Performance profile of FDG-PET and PET/CT for cancer screening on the basis of a Japanese Nationwide Survey. Ann Nucl Med 2007;21:481–491.
Harris RP, Helfand M, Woolf SH, Lohr KN, Mulrow CD, Teutch SM, et al. Current methods of the U.S. Preventive Services Task Force: a review of the process. Am J Prev Med 2001;20(3S):21–35.
Jinnouchi S, Nakajo M, Tateno R, Tanabe H. Analysis of colon cancer detected in cancer screening with FDG-PET: comparing with Feces occult blood test and CEA (in Japanese). Nihon Gan-Kenshinn Shindan Gakkaishi 2007;14:150–155.
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Terauchi, T., Murano, T., Daisaki, H. et al. Evaluation of whole-body cancer screening using 18F-2-deoxy-2-fluoro-d-glucose positron emission tomography: a preliminary report. Ann Nucl Med 22, 379–385 (2008). https://doi.org/10.1007/s12149-008-0130-7
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DOI: https://doi.org/10.1007/s12149-008-0130-7