Performance profile of FDG-PET and PET/CT for cancer screening on the basis of a Japanese Nationwide Survey.
OBJECTIVE
The aim of this study is to survey the situation of (18)F-fluorodeoxyglucose-positron emission tomography (FDG-PET) cancer screening in Japan and to describe its performance profile.


METHODS
"FDG-PET for 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. We sent questionnaires regarding FDG-PET cancer screening to 99 facilities in which FDG-PET tests were performed during the fiscal year 2005. Replies were obtained from 68 of the 99 facilities, of which 46 facilities performed FDG-PET cancer screening. The total number of subjects who underwent FDG-PET cancer screening was 50 558. From 38 of 46 facilities, reliable results of thorough examinations were obtained for the subjects who were positive by FDG-PET and/or one or more of the combined screening tests was performed and were referred for further evaluation. The total number of subjects in these 38 facilities amounted to 43 996.


RESULTS
A total of 50,558 healthy subjects underwent FDG-PET (including PET/CT) scanning with or without other tests for cancer screening in 46 PET centers during the fiscal year of 2005 in Japan. Thorough examination was indicated for 9.8% of the cases as a result of positive findings suggesting possible cancer. On analyzing 43 996 cases from 38 PET centers from which detailed information was obtained, 500 cases of cancers (1.14%) were found, of which 0.90% were PET positive and 0.24% were PET negative, resulting in the relative sensitivity of PET being 79.0%. Cancers of the thyroid, colon/rectum, lung, and breast were most frequently found (107, 102, 79, and 35 cases, respectively) with high PET sensitivity (88%, 90%, 80%, and 92%). PET showed an overall positive predictive value of 29.0%. PET/CT had a better detection rate, sensitivity, and positive predictive value than dedicated PET (P < 0.01).


CONCLUSIONS
We were able to clarify the performance profile of "FDG-PET for cancer screening" on the basis of a Japanese nationwide survey. The number of facilities possessing PET is increasing steadily, highlighting the necessity of evaluating the usefulness of "FDG-PET cancer screening" as soon as possible by undertaking long-term investigations of large series of subjects.
Minamimoto
Ryogo
R
Department of Radiology, Yokohama City University, Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. t046047b@yokohama-cu.ac.jp
Senda
Michio
M
Uno
Kimiichi
K
Jinnouchi
Seishi
S
Iinuma
Takeshi
T
Ito
Kengo
K
Okuyama
Chio
C
Oguchi
Kazuhiro
K
Kawamoto
Masami
M
Suzuki
Yutaka
Y
Tsukamoto
Eriko
E
Terauchi
Takashi
T
Nakashima
Rumi
R
Nishio
Masami
M
Nishizawa
Sadahiko
S
Fukuda
Hiroshi
H
Yoshida
Tsuyoshi
T
Inoue
Tomio
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005189:False Positive Reactions; D005260:Female; D019788:Fluorodeoxyglucose F18; D019538:Health Care Surveys; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000706:statistics & numerical data; D007564:Japan; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000295:instrumentation / Q000706:statistics & numerical data; D009369:Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D015397:Program Evaluation / Q000706:statistics & numerical data; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18