Prospective Evaluation of Whole-Body Cancer Screening With Multiple Modalities Including [<sup>18</sup>F]Fluorodeoxyglucose Positron Emission Tomography in a Healthy Population: A Preliminary Report

Nishizawa, Sadahiko; Kojima, Shinsuke; Teramukai, Satoshi; Inubushi, Masayuki; Kodama, Hironobu; Maeda, Yoshiki; Okada, Hiroyuki; Zhou, Bin; Nagai, Yoji; Fukushima, Masanori

doi:10.1200/jco.2008.18.2238

Cited by 49 publications

(32 citation statements)

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“…FDG-PET was performed using an SHR-92000 scanner (Hamamatsu Photonics K.K., Hamamatsu, Japan), starting 60 min after an injection of 3 MBq/kg body weight FDG to a subject who had fasted for at least 5 hours [16]. Serum glucose levels were measured just before the FDG injection.…”

Section: Methodsmentioning

confidence: 99%

High incidence of thyroid cancer in focal thyroid incidentaloma detected by 18F-fluorodexyglucose positron emission tomography in relatively young healthy subjects: results of 3-year follow-up

et al. 2010

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Abstract. As 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is becoming a common imaging modality, the number of thyroid incidentalomas identified by FDG-PET (PET incidentaloma) is increasing. The purpose of this study was to elucidate the risk of cancer in focal thyroid PET incidentaloma in healthy subjects of relatively younger age as well as the usefulness of repeated FDG-PET. The study was conducted with an observation period of three years. A total of 1,501 healthy volunteers (mean age, 43.5±9.7 years) underwent the first FDG-PET from August 2003 to July 2004. When focal thyroid PET incidentaloma was found, further diagnostic examination was conducted. When thyroid cancer was suspected, surgical resection was performed with the patient's agreement. Patients with PET incidentaloma without surgery were offered annual US and FDG-PET and finally FNAB was performed in the fourth year. Focal thyroid PET incidentaloma was observed in 20 subjects. The final diagnoses in 20 subjects were malignant in 11 (ten papillary thyroid carcinoma (PTC) and one thyroid carcinoma showing thymus-like differentiation), indeterminate in one, and benign in eight subjects. Seven patients not treated surgically at the first examination had annual FDG-PET. One patient with PTC showed increasing SUVmax, but another with a benign nodule exhibited a similar increase. Others (one with PTC, one with an indeterminate nodule, and three with benign nodules) exhibited negligible SUVmax changes. When closely examined, focal thyroid PET incidentaloma in relatively young healthy adults has a high probability of malignancy. Repeated FDG-PET to follow up patients with thyroid nodules is ineffective.

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Section: Methodsmentioning

confidence: 99%

High incidence of thyroid cancer in focal thyroid incidentaloma detected by 18F-fluorodexyglucose positron emission tomography in relatively young healthy subjects: results of 3-year follow-up

et al. 2010

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“…Although PET has recently been proposed as a promising cancer screening test [47,48], the utility of PET in gastric cancer screening has not been evaluated. For gastric cancer screening, the usefulness of PET is limited because of physiological FDG uptake in the normal gastric wall and differences of FDG uptake according to the histological type of the tumor [1,2].…”

Section: Efficacy Of Pet For the Screening Of Gastric Cancermentioning

confidence: 99%

Japanese Gastric Cancer Association Task Force for Research Promotion: clinical utility of 18F-fluoro-2-deoxyglucose positron emission tomography in gastric cancer. A systematic review of the literature

et al. 2011

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Since April 2010, the Japanese Public Health Insurance System has covered the costs incurred for performing 18 F-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) imaging for patients with advanced gastric cancer. The aim of this review was to evaluate the clinical impact of PET for patients with gastric cancer. A systematic literature search was performed in PubMed/MEDLINE using the keywords ''gastric cancer'' and ''PET'' to search for relevant articles published from January 2000 to September 2010. The clinical impact of selected articles was assessed by the authors to evaluate the following: (a) tumor staging, (b) diagnosis for recurrent disease, (c) evaluation of treatment response, and (d) screening for gastric cancer. FDG uptake increases in papillary adenocarcinoma, tubular adenocarcinoma, and solid-type poorly differentiated adenocarcinoma. This uptake is also associated with glucose transporter 1 expression. The sensitivity and specificity of FDG-PET for metastatic lymph node detection were 21-40% and 89-100%, respectively. The sensitivity and specificity for distant metastasis detection were 35-74% and 74-99%, respectively. Treatment response can be detectable at an earlier stage by PET than by computed tomography (CT), because FDG uptake by cancer cells decreases according to the treatment response. In summary, although PET has limitations such as frequent false-negative cases in signetring cell carcinoma and non-solid type poorly differentiated carcinoma, it can contribute to the selection of a more appropriate treatment modality by detecting distant metastases and treatment response.

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“…[8][9][10][11][12][13][14][15] Table 1 summarizes the findings of these reports. The rate of detected incidental foci ranges from 3.0% to 12.3%.…”

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confidence: 93%

“…[8][9][10][11][12][13] The detection rate of IC ranges from 0.9% to 4.4%, [8][9][10][11][12][13][14][15] and a few reports have described a wider range (0.1-4.4%) of false-negative findings. [13][14][15] However, the survival of patients with IC has not been detailed. Differences in detection rates and other findings arise owing to many factors, including country, age, symptomatic or asymptomatic individuals, 18 F-FDG PET or PET/CT, judgment criteria, method and period of follow-up.…”

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confidence: 99%

Ability of 18-fludeoxyglucose positron emission tomography/CT to detect incidental cancer

Sone

Sobajima²,

Kawachi³

et al. 2014

BJR

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Objective: To determine the prevalence and clinical features of pathologically proven incidental cancer (IC) detected by whole-body fluorine-18 fludeoxyglucose ( 18 F-FDG) positron emission tomography (PET)/CT, as well as the incidence of false-positive and false-negative results. Methods: We retrospectively reviewed reports derived from 18 F-FDG PET/CT images of 3079 consecutive patients with known or suspected malignancies for 3 years. Discrete focal uptake indicating IC was identified from reports as well as pathological or clinical diagnoses, and the clinical courses were investigated. The false-positive result was defined as uptake indicating IC but not pathologically confirmed as malignant during follow-up. The false-negative result was defined as pathologically proven IC detected by another modality at initial clinical work-up or diagnosed during the follow-up period. Results: We found 18 F-FDG uptake indicating IC in 6.7% of all patients, and IC was pathologically proven in 2.2% of all patients. The most common sites were the colon, lung and stomach. The median survival duration of patients with IC was 42 months. The results were false positive in 4.5% of all patients, and the results were false negative in 2.3% of all patients. Conclusion:18 F-FDG PET/CT is a valuable tool for detecting IC. The rates of false-positive and false-negative results are within acceptable range. Advances in knowledge: This is the first report to describe the survival of patients with IC, and the detailed features of false-negative results at actual clinical settings.

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Prospective Evaluation of Whole-Body Cancer Screening With Multiple Modalities Including [¹⁸F]Fluorodeoxyglucose Positron Emission Tomography in a Healthy Population: A Preliminary Report

Cited by 49 publications

References 18 publications

High incidence of thyroid cancer in focal thyroid incidentaloma detected by 18F-fluorodexyglucose positron emission tomography in relatively young healthy subjects: results of 3-year follow-up

High incidence of thyroid cancer in focal thyroid incidentaloma detected by 18F-fluorodexyglucose positron emission tomography in relatively young healthy subjects: results of 3-year follow-up

Japanese Gastric Cancer Association Task Force for Research Promotion: clinical utility of 18F-fluoro-2-deoxyglucose positron emission tomography in gastric cancer. A systematic review of the literature

Ability of 18-fludeoxyglucose positron emission tomography/CT to detect incidental cancer

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Prospective Evaluation of Whole-Body Cancer Screening With Multiple Modalities Including [18F]Fluorodeoxyglucose Positron Emission Tomography in a Healthy Population: A Preliminary Report

Cited by 49 publications

References 18 publications

High incidence of thyroid cancer in focal thyroid incidentaloma detected by 18F-fluorodexyglucose positron emission tomography in relatively young healthy subjects: results of 3-year follow-up

High incidence of thyroid cancer in focal thyroid incidentaloma detected by 18F-fluorodexyglucose positron emission tomography in relatively young healthy subjects: results of 3-year follow-up

Japanese Gastric Cancer Association Task Force for Research Promotion: clinical utility of 18F-fluoro-2-deoxyglucose positron emission tomography in gastric cancer. A systematic review of the literature

Ability of 18-fludeoxyglucose positron emission tomography/CT to detect incidental cancer

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Prospective Evaluation of Whole-Body Cancer Screening With Multiple Modalities Including [¹⁸F]Fluorodeoxyglucose Positron Emission Tomography in a Healthy Population: A Preliminary Report