Department of Radiology, National Center for Global Health and Medicine, Shinjyuku-ku, Tokyo, Japan.
Ann Nucl Med. 2011 Jan;25(1):45-54. doi: 10.1007/s12149-010-0428-0. Epub 2010 Oct 17.
The most distinctive feature of FDG-PET cancer screening program is the ability to find various kinds of malignant neoplasms in a single test. The aim of this survey is to clarify the range and frequency of various malignant neoplasms detected by FDG-PET cancer screening performed in Japan.
"FDG-PET cancer screening" was defined as FDG-PET or positron emission tomography and computed tomography (PET/CT) scan with or without other tests performed for cancer screening of healthy subjects. This survey was based on a questionnaire regarding FDG-PET cancer screening. We analyzed the situation of 9 less frequently found malignant neoplasms including malignant lymphoma, malignancy of head and neck, esophagus, hepatobiliary and gallbladder, pancreas, kidney, cervical and uterine, ovary, and bladder.
The detailed information of subjects with the suspected 9 kinds of malignant neoplasms mentioned above in the FDG-PET cancer screening program was studied in a total of 1,219 cases from 212 facilities. A statistical significance between PET/CT and PET was found in relative sensitivity and PPV for renal cell cancer. Malignant lymphoma was frequently of indolent type, suspected head and neck cancers had many false-positive results, and pancreatic cancer detected in this program was often in the advanced stage even in asymptomatic subjects. The recommendation of combined screening modality to PET or PET/CT was as follows: gastric endoscopy for assessing early esophageal cancer; abdominal ultrasound for screening hepatobiliary and gallbladder cancer; pelvic magnetic resonance imaging for assessing gynecological and pelvic cancers; and the CA125 blood test for screening ovarian cancer. Delayed image was helpful depending on the type of suspected malignant neoplasm.
We analyzed various types of malignant neoplasms detected by the FDG-PET cancer screening program and presented recommended combination of examinations to cover FDG-PET and PET/CT.
FDG-PET 癌症筛查项目的最显著特点是能够在单次检查中发现各种恶性肿瘤。本调查旨在阐明日本进行的 FDG-PET 癌症筛查中检测到的各种恶性肿瘤的范围和频率。
“FDG-PET 癌症筛查”定义为对健康受试者进行的 FDG-PET 或正电子发射断层扫描和计算机断层扫描（PET/CT）扫描，伴或不伴其他检查。本调查基于一份关于 FDG-PET 癌症筛查的问卷。我们分析了包括恶性淋巴瘤、头颈部、食管、肝胆和胆囊、胰腺、肾脏、宫颈和子宫、卵巢和膀胱等 9 种较少见的恶性肿瘤的情况。
在 212 个机构的 1219 例患者中，对 FDG-PET 癌症筛查项目中疑似上述 9 种恶性肿瘤患者的详细信息进行了研究。在相对灵敏度和 PPV 方面，PET/CT 和 PET 之间存在统计学差异。恶性淋巴瘤多为惰性类型，疑似头颈部癌症有许多假阳性结果，该项目中检测到的胰腺癌即使在无症状患者中也往往处于晚期。建议对 PET 或 PET/CT 进行联合筛查模式如下：胃内窥镜检查用于评估早期食管癌；腹部超声用于筛查肝胆和胆囊癌；盆腔磁共振成像用于评估妇科和盆腔癌症；CA125 血液检查用于筛查卵巢癌。根据疑似恶性肿瘤的类型，延迟成像可能会有所帮助。
我们分析了 FDG-PET 癌症筛查项目中检测到的各种恶性肿瘤，并提出了推荐的联合检查，以涵盖 FDG-PET 和 PET/CT。
