PET with 2-[F-18]-fluoro-2-deoxy-D-glucose (FDG) in patients with cancer of unknown primary (CUP): influence on patients' diagnostic and therapeutic management.
25 patients with cancer of unknown primary (CUP) were studied using PET-FDG. Whole-body-PET scans were performed based on previous morphological information. All patients underwent conventional diagnostic modalities prior to and after the PET-study. True positive results were obtained in 12/25 patients (48%) and the primary identified by PET was confirmed by further procedures. True negative results were obtained in 8/25 patients (32%) and no primary tumor was found by PET or other clinical investigations. False positive results were obtained in 5/25 patients (20%). No false negative results were obtained. In 11 patients having CT compared with PET the primary tumor was exclusively localized by PET in 8 patients (73%) and also by CT in 3 patients (27%); CT was unable to identify the tumor in 8/11 patients detected by PET. PET affected management and directed treatment in 11/25 patients (44%). The sensitivity of PET-FDG was 100%, specificity 61%. These observations demonstrate that PET-FDG is a highly sensitive method to detect CUP. Correctly classified patients in an early stage of disease may lead to benefit from a more targeted therapy with prolonged survival time. In cases of advanced disease PET might not decisively influence survival time.
Mantaka
Panagiota
P
Department of Radiology, Clinic of Nuclear Medicine, Johann Wolfgang Goethe University of Frankfurt, Frankfurt, Germany. pmantaka@web.de
Baum
Richard P
RP
Hertel
Andreas
A
Adams
Stefan
S
Niessen
Andreas
A
Sengupta
Sonali
S
Hör
Gustav
G
D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000000981:diagnostic imaging* / Q000628:therapy; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18