title: Cancer screening with whole-body PET/CT for healthy asymptomatic people in Japan: re-evaluation of its test validity and radiation exposure.
abstract: The use of Positron Emission Tomography (PET) or PET/CT for voluntary cancer screening of asymptomatic individuals is becoming common in Japan, though the utility of such screening is still controversial. This study estimated the general test validity and effective radiation dose for PET/CT cancer screening of healthy Japanese people by evaluating four standard indices (sensitivity, specificity, positive/negative predictive values), and predictive values with including prevalence for published literature and simulation-based Japanese data. CT and FDG-related dosage data were gathered from the literature and then extrapolated to the scan parameters at a model PET center. We estimated that the positive predictive value was only 3.3% in the use of PET/CT for voluntary cancer screening of asymptomatic Japanese individuals aged 50-59 years old, whose average cancer prevalence was 0.5%. The total effective radiation dose of a single whole-body PET/CT scan was estimated to be 6.34 to 9.48 mSv for the average Japanese individual, at 60 kg body weight. With PET/CT cancer screening in Japan, many healthy volunteers screened as false positive are exposed to at least 6.34 mSv without getting any real benefit. More evaluation concerning the justification of applying PET/CT for healthy people is necessary.
authors.affiliation: Takashi Nagai Memorial International Hibakusha Medical Center, Nagasaki University Hospital, Nagasaki City, Japan.
authors.forename: Nader
authors.initials: N
authors.lastname: Ghotbi
authors.forename: Masako
authors.initials: M
authors.lastname: Iwanaga
authors.forename: Akira
authors.initials: A
authors.lastname: Ohtsuru
authors.forename: Yoji
authors.initials: Y
authors.lastname: Ogawa
authors.forename: Shunichi
authors.initials: S
authors.lastname: Yamashita
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004781:Environmental Exposure; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009369:Neoplasms / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D011829:Radiation Dosage; D019275:Radiopharmaceuticals; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D051598:Whole Body Imaging
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18