The current status of an FDG-PET cancer screening program in Japan, based on a 4-year (2006–2009) nationwide survey

Minamimoto, Ryogo; Senda, Michio; Jinnouchi, Seishi; Terauchi, Takashi; Yoshida, Tsuyoshi; Murano, Tatsuro; Fukuda, Hiroshi; Iinuma, Takeshi; Uno, Kimiichi; Nishizawa, Sadahiko; Tsukamoto, Eriko; Iwata, Hiroshi; Inoue, Takeshi; Oguchi, Kazuhiro; Nakashima, Rumi; Inoue, Tomio

doi:10.1007/s12149-012-0660-x

Cited by 66 publications

(49 citation statements)

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“…In the so far largest 18 F-FDG PET screening study performed at 233 facilities with inclusion of 155,456 subjects, positive 18 F-FDG PET findings suggesting possible cancer were found in 10.9% of the cases. However, on the basis of further investigations the true-positive (TP) rate (positive predictive value) was only 32.3% (26). Accordingly, this large-scale study clearly demonstrated that 18 F-FDG PET had a far-too-high FP rate to be applied as screening of the general population.…”

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confidence: 71%

“…In a previous study of 18 F-FDG PET as the primary imaging modality, which was performed in a low-prevalence (1%) population, it was clearly demonstrated that 18 F-FDG PET was of limited value because of the high FP rate (26). However, in the recently established nationwide DOCs in Denmark, the prevalence of cancer is much higher and around 16%-18% (9,10).…”

Section: Discussionmentioning

confidence: 99%

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Whole-Body ¹⁸F-FDG PET/CT Is Superior to CT as First-Line Diagnostic Imaging in Patients Referred with Serious Nonspecific Symptoms or Signs of Cancer: A Randomized Prospective Study of 200 Patients

et al. 2017

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A fast-track pathway has been established in Denmark to investigate patients with serious nonspecific symptoms and signs of cancer (NSSC), who are not eligible to enter an organ-specific cancer program. The prevalence of cancer in this cohort is approximately 20%. The optimal screening strategy in patients with NSSC remains unknown. The aim of the study was to investigate whether 18 F-FDG PET/CT was superior to CT as an initial imaging modality in patients with NSSC. In a randomized prospective trial, the imaging modalities were compared with regard to diagnostic performance. Methods: Two hundred patients were randomized 1:1 to whole-body 18 F-FDG PET/CT or CT of the thorax and abdomen as the imaging modality. A tentative diagnosis was established after first-line imaging. The final referral diagnosis was adjudicated by the physician, when sufficient data were available. Results: One hundred ninety-seven patients were available for analysis because 3 patients withdrew consent before scanning. Thirty-nine (20%) patients were diagnosed with cancer, 10 (5%) with an infection, 15 (8%) with an autoimmune disease, and 76 (39%) with other diseases. In the remaining 57 patients (28%), no specific disease was found. 18 F-FDG PET/CT had a higher specificity (96% vs. 85%; P 5 0.028) and a higher accuracy (94% vs. 82%; P 5 0.017) than CT. However, there were no statistically significant differences in sensitivity (83% vs. 70%) or negative predictive values (96% vs. 92%). No difference in days to final referral diagnosis according to randomization group could be shown (7.2 vs. 7.6 d). However, for the subgroups in which the imaging modality showed a suggestion of malignancy, there was a significant delay to final diagnosis in the CT group compared with the 18 F-FDG PET/CT group (11.6 vs. 5.7 d; P 5 0.02). Conclusion: Compared with CT, we found a higher diagnostic specificity and accuracy of 18 F-FDG PET/CT for detecting cancer in patients with NSSC. 18 F-FDG PET/CT should therefore be considered as first-line imaging in this group of patients. In2009,f ast-track cancer patient pathways were introduced by the Danish Health and Medicine Authority for patients with nonspecific symptoms and signs of cancer (NSSC) in Denmark. The background for the implementation was that Danish patients experience poorer cancer survival rates than patients from other European countries and were diagnosed with an unfavorable delay (1-4). Since 2012, Diagnostic Outpatient Clinics (DOC) have been established in the Capital Region of Denmark for patients with NSSC because early diagnosis in cancer is of importance for a more favorable outcome (5-8). The criterion for referral to DOC was a suspicion from the referring physicians, in more than 95% of the cases the patient's general practitioner, that the patient had an NSSC. The referral was typically prompted by one or more of the following observations: increasing health service-seeking behavior; weight loss; tiredness; or a group of unspecific symptoms, which did not fit into any of the organ-speci...

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confidence: 71%

Section: Discussionmentioning

confidence: 99%

Whole-Body ¹⁸F-FDG PET/CT Is Superior to CT as First-Line Diagnostic Imaging in Patients Referred with Serious Nonspecific Symptoms or Signs of Cancer: A Randomized Prospective Study of 200 Patients

et al. 2017

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“…On the other hand, although 2-[ 18 F]fluoro-2-deoxyglucose (FDG) positron emission tomography (PET), including PET combined with CT (PET/CT), has been increasingly used to screen patients for whole-body cancers, including CRC [9][10][11], the sensitivity of FDG-PET in CRC screening has not been fully analyzed. FDG-PET is a noninvasive functional imaging modality that reflects the change in glucose metabolism in tumor cells, and has been applied in oncology [12].…”

Section: Introductionmentioning

confidence: 99%

Sensitivity of 2-[18F]fluoro-2-deoxyglucose positron emission tomography for advanced colorectal neoplasms: a large-scale analysis of 7505 asymptomatic screening individuals

Sekiguchi

Kakugawa²,

Terauchi³

et al. 2016

J Gastroenterol

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“…Furthermore, the use for cancer screening in general population was still under debate because many benign lesions such as supraclavicular fat pads, nodular goiter, and benign prostatic hypertrophy could also be shown as high uptakes. It could lead to unnecessary and potentially invasive investigations with extra cost, risks, and anxiety to patients [34].…”

Section: Limitations Of Pet-ctmentioning

confidence: 99%

The Use of PET-CT in Rheumatology

2017

Hong Kong Bulletin on Rheumatic Diseases

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(bismuth germanium oxide, lutetium oxyorthosilicate, and cerium-doped gadollium oxyorthosilicate). These scintillators are used to detect the gamma rays emitted from those foci that concentrated with the radiolabeled glucose ( Figure 1). They will convert gamma rays to light signals and followed by electric signals that can be displayed on a monitor. However, photons originated from structures deeper in the body are more attenuated than those originating closer to the surface. This attenuation can leads to false interpretation. In order to correct this, the CT scan can generate an attenuation map or coefficients that can be used to correct this attenuation effect. Once scaled, they can be applied to the emission data to obtain the attenuation-corrected image. Apart from improving the image quality, this correction process is also essential Abstract: Positron emission tomography (PET) is a sensitive imaging tool that gives quantitative measure of underlying inflammation. Computed tomography (CT) scan used in combination with PET further helps to delineate the anatomical structure. PET-CT can be helpful for the early diagnosis of rheumatic diseases by pattern recognition, but its role in disease monitoring still needs further evaluation. It is not a fast track solution for all because of different sensitivity and specificity to different diseases, relative high cost, and radiation exposure to the patients. Keywords: PET-CT, inflammatory diseases Background and technical aspects of PET-CTPositron emission tomography-computed tomography (PET-CT) is the fusion of functional and anatomic scan that acquired almost simultaneously. It helps us to visualize the form and activity of potential diseases within the body. It is now a popular nuclear imaging modality for the evaluation of cancer, fever or inflammation of unknown origin. The differential diagnosis sometimes includes the rheumatic disorders. It is based on the fact that the glucose transporters are up regulated on cell membrane secondary to the hypoxic drive in the highly proliferative cells such as tumor or aggregated inflammatory cells. The increase in metabolism of these cells can be reflected by the increased uptake of radiolabeled glucose such as 18 fluorine-2-fluoro-2-deoxy-d-glucose ( 18 F-FDG) [1].Inside the machine, there is a PET portion which is physically mounted together with the CT system. PET images are fitted with various crystals called scintillators

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The current status of an FDG-PET cancer screening program in Japan, based on a 4-year (2006–2009) nationwide survey

Cited by 66 publications

References 18 publications

Whole-Body ¹⁸F-FDG PET/CT Is Superior to CT as First-Line Diagnostic Imaging in Patients Referred with Serious Nonspecific Symptoms or Signs of Cancer: A Randomized Prospective Study of 200 Patients

Whole-Body ¹⁸F-FDG PET/CT Is Superior to CT as First-Line Diagnostic Imaging in Patients Referred with Serious Nonspecific Symptoms or Signs of Cancer: A Randomized Prospective Study of 200 Patients

Sensitivity of 2-[18F]fluoro-2-deoxyglucose positron emission tomography for advanced colorectal neoplasms: a large-scale analysis of 7505 asymptomatic screening individuals

The Use of PET-CT in Rheumatology

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The current status of an FDG-PET cancer screening program in Japan, based on a 4-year (2006–2009) nationwide survey

Cited by 66 publications

References 18 publications

Whole-Body 18F-FDG PET/CT Is Superior to CT as First-Line Diagnostic Imaging in Patients Referred with Serious Nonspecific Symptoms or Signs of Cancer: A Randomized Prospective Study of 200 Patients

Whole-Body 18F-FDG PET/CT Is Superior to CT as First-Line Diagnostic Imaging in Patients Referred with Serious Nonspecific Symptoms or Signs of Cancer: A Randomized Prospective Study of 200 Patients

Sensitivity of 2-[18F]fluoro-2-deoxyglucose positron emission tomography for advanced colorectal neoplasms: a large-scale analysis of 7505 asymptomatic screening individuals

The Use of PET-CT in Rheumatology

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Whole-Body ¹⁸F-FDG PET/CT Is Superior to CT as First-Line Diagnostic Imaging in Patients Referred with Serious Nonspecific Symptoms or Signs of Cancer: A Randomized Prospective Study of 200 Patients

Whole-Body ¹⁸F-FDG PET/CT Is Superior to CT as First-Line Diagnostic Imaging in Patients Referred with Serious Nonspecific Symptoms or Signs of Cancer: A Randomized Prospective Study of 200 Patients