Cengiz Arzu, Göksel Sibel, Yürekli Yakup
Adnan Menderes University Faculty of Medicine, Department of Nuclear Medicine, Aydın, Turkey
Mol Imaging Radionucl Ther. 2018 Oct 9;27(3):126-132. doi: 10.4274/mirt.64426.
The aim of this study is to investigate the clinical role of F-fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) in patients with carcinoma of unknown primary (CUP).
One hundred twenty one patients with a diagnosis of CUP who underwent whole body F-FDG PET/CT imaging were included in this retrospective study. The final diagnoses were confirmed either histopathologically or by clinical follow-up.
The F-FDG-PET/CT successfully detected the primary tumor in 59 out of 121 (49%) patients. The most common primary tumor as detected by F-FDG PET/CT was lung cancer (n=31). In a patient, two primary tumors (colon and prostate) were detected on PET/CT imaging. Bone marrow biopsy revealed prostate cancer in this patient and the colon cancer was accepted as a synchronous second primary tumor. F-FDG PET/CT findings were false-positive in 11 patients. F-FDG PET/CT could not detect any primary lesion in 51 patients, whose conventional work-up detected a primary tumor in 11 and thus considered as false-negative. The sensitivity, specificity rate and accuracy of F-FDG PET/CT in detection of primary tumor were identified as 84%, 78% and 82%, respectively.
Whole body F-FDG PET/CT is an effective method for detecting the primary tumor in patients with CUP. In addition to detecting the primary tumor, it can also help determine disease extent and contribute to patient management.
本研究旨在探讨¹⁸F-氟脱氧葡萄糖（¹⁸F-FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）在不明原发癌（CUP）患者中的临床作用。
本回顾性研究纳入了121例诊断为CUP且接受了全身¹⁸F-FDG PET/CT成像的患者。最终诊断通过组织病理学或临床随访得以证实。
¹⁸F-FDG-PET/CT在121例患者中的59例（49%）中成功检测到原发肿瘤。¹⁸F-FDG PET/CT检测到的最常见原发肿瘤是肺癌（n = 31）。在一名患者中，PET/CT成像检测到两个原发肿瘤（结肠和前列腺）。骨髓活检显示该患者为前列腺癌，结肠癌被视为同步性第二原发肿瘤。¹⁸F-FDG PET/CT检查结果在11例患者中为假阳性。¹⁸F-FDG PET/CT在51例患者中未检测到任何原发灶，而这些患者的传统检查发现了11例原发肿瘤，因此被视为假阴性。¹⁸F-FDG PET/CT检测原发肿瘤的敏感性、特异性和准确性分别为84%、78%和82%。
全身¹⁸F-FDG PET/CT是检测CUP患者原发肿瘤的有效方法。除了检测原发肿瘤外，它还可以帮助确定疾病范围并有助于患者管理。
