Prevalence of additional primary malignancies detected incidentally on PET/CT

Lee, Joseph C.; Teles, Marcelo Santos

doi:10.1590/0100-3984.2019.0097

Cited by 3 publications

(4 citation statements)

References 4 publications

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“…The detection rate in this study (3.26%) in relatively in concordance to Ali et al [10], who had shown similar detection rate 13 out of 273 patients (4.76%) with the lower PPV of 56.5% and sensitivity of 89.2% and discordance to Servente et al [11] who showed less detection rate (1.2%, 49/4086) and Tibana and Lee [3,12] who had shown lesser detection rate (1.1).…”

Section: Discussionsupporting

confidence: 90%

Detection of additional primary malignant tumor in cancer survivors: the use of PET/CT for image-guided biopsy

Shaban

Saleh

2020

Egypt J Radiol Nucl Med

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Background PET/CT is a well-established tool in the diagnostic workup of oncology patients. With the advance in diagnosis and therapy of oncology patients, survivors are at risk of developing additional malignancies. This study aimed to evaluate the yield of 18F-FDG PET/CT in biopsy guidance for the detection of unexpected additional primary malignancies in patients with known primary cancers. Medical records of patients underwent 18F-FDG PET/CT scans from July 2015 to December 2017 were reviewed, and 644 patients (346 men and 298 women; mean age 59.7, age range from 21: 78) who had been scanned for known cancers were included in this study. Lesions that were newly detected on PET/CT had not been previously detected by other modalities and were atypical in location for metastases were interpreted as suggestive of a new primary malignant tumor. These image findings guide the biopsy for histopathology, immune-histochemistry to confirm the diagnosis. Results PET-positive findings suggestive of new primary malignant tumors were found in 30 (4.67%) of 644 patients. In 21 (3.26%) of 644 patients, these lesions were pathologically proven to be malignant (20 true positive and 1 case false negative). Proven sites were lung (5 cases), colorectal (5 cases), breast (2 case), liver (2 cases), head and neck (2 cases), anal (1 cases), gastric (1 case), lymphoma (1 case), esophagus (1 case), and prostate (1 case). In 9/30 (30%) patients suspected to have additional primary, PET was falsely positive. Biopsy was taken for histology and immune-histochemistry with follow-up record that confirms the diagnosis to validate the PET/CT findings. Conclusions With the use of 18-F FDG PET/CT image- guided biopsy, additional primary malignancies were detected in at least 3.26% of oncology patients; thus, patient cure is possible if such malignancies are treated promptly and aggressively.

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Section: Discussionsupporting

confidence: 90%

Detection of additional primary malignant tumor in cancer survivors: the use of PET/CT for image-guided biopsy

Shaban

Saleh

2020

Egypt J Radiol Nucl Med

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“…Although PET/CT is increasingly being used as the modality of choice for staging neoplasms (19)(20)(21)(22)(23)(24)(25) , exposure to even small doses of ionizing radiation may increase the risk of later radiation-induced malignancies, particularly in children (26,27) . Any PET/CT examination for staging or for the assessment of treatment response should be conducted after a clear evaluation of the risks of radiation exposure relative to the intended benefits.…”

Section: Discussionmentioning

confidence: 99%

“…All of the studies included children and adolescents with histopathological confirmation of the primary tumor. The mean sample size was 23 (range, [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. Of the 118 patients, 45 (66%) were male.…”

Section: Characteristics Of the Studies Included In The Systematic Review And Meta-analysismentioning

confidence: 99%

Whole-body magnetic resonance imaging for the diagnosis of metastasis in children and adolescents: a systematic review and meta-analysis

et al. 2021

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Whole-body magnetic resonance imaging (WB-MRI) is a noninvasive imaging method that can be used to diagnose and stage tumors, as well as to assess therapeutic responses in oncology. The objective of this meta-analysis was to evaluate the accuracy of WB-MRI for the diagnosis of metastases in pediatric patients. The following electronic databases were searched: Medline, Embase, Cochrane Central Register of Controlled Trials, Scientific Electronic Library Online, Latin-American and Caribbean Health Sciences Literature, Cumulative Index to Nursing and Allied Health Literature, Web of Science, and ClinicalTrials.gov. All of the selected studies included children and adolescents with histopathological confirmation of a primary tumor. Collectively, the studies included 118 patients ranging in age from 7 months to 19 years. The pooled sensitivity and specificity of WB-MRI were, respectively, 0.964 (95% CI: 0.944-0.978; I2 = 0%) and 0.902 (95% CI: 0.882-0.919; I2 = 98.4%), with an area under the curve (AUC) of 0.991. We found that WB-MRI had good accuracy for the diagnosis of metastases in pediatric patients and could therefore provide an alternative to complete the staging of tumors in such patients, being a safer option because it does not involve the use of ionizing radiation.

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“…To date, there is no universal diagnostic technique with overall oncologic accuracy, neither are there diagnostic guidelines to detect synchronous MPMs [6]. The choice between CT, magnetic resonance imaging (MRI), positron emission tomography (PET), and even ultrasound (US) depends on the tumour type or body region [19,20].…”

Section: Discussionmentioning

confidence: 99%

Synchronous tumours detected during cancer patient staging: prevalence and patterns of occurrence in multidetector computed tomography

et al. 2020

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The incidental detection of one or more additional primary tumours during computed tomography (CT) staging of a patient with known malignancy is rare but possible. This occurrence should be considered by the radiologist when a new lesion is detected, especially if the lesion location is atypical for metastases. The purpose of this report was to document the usefulness of total body CT scan to detect synchronous primary malignancies in cancer patients undergoing a staging workup. Material and methods: This was done by reviewing the staging CT studies of the adult patients with a newly diagnosed cancer evaluated during a five-year period in a single cancer institute in order to identify any possible correlation, establishing which tumours are more frequently combined with a second tumour and which second tumours are more commonly present. Results: Among the patients with a second tumour, the most frequent first primary tumours were melanoma (eight patients, 17.8%), lymphoma (seven patients, 15.6%), and prostate carcinoma (seven patients, 15.6%). The most frequent incidentally detected second tumours were hepatocellular carcinoma (nine patients, 20% of 45 incidental tumours), renal carcinoma (eight patients, 17.8%), lung carcinoma (seven patients, 15.6%), and bladder carcinoma (four patients, 8.9%). One patient had three primary tumours synchronously. Conclusions: We believe that the radiologist's knowledge of the prevalence and pattern of occurrence of these multiple primary malignancies represents added diagnostic value.

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Prevalence of additional primary malignancies detected incidentally on PET/CT

Cited by 3 publications

References 4 publications

Detection of additional primary malignant tumor in cancer survivors: the use of PET/CT for image-guided biopsy

Detection of additional primary malignant tumor in cancer survivors: the use of PET/CT for image-guided biopsy

Whole-body magnetic resonance imaging for the diagnosis of metastasis in children and adolescents: a systematic review and meta-analysis

Synchronous tumours detected during cancer patient staging: prevalence and patterns of occurrence in multidetector computed tomography

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