Analysis of various malignant neoplasms detected by FDG-PET cancer screening program: based on a Japanese Nationwide Survey.
OBJECTIVE
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.


METHODS
"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.


RESULTS
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.


CONCLUSIONS
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.
Department of Radiology, National Center for Global Health and Medicine, Shinjyuku-ku, Tokyo, Japan. ryogominamimoto@yahoo.co.jp
Ryogo
R
Minamimoto
Michio
M
Senda
Takashi
T
Terauchi
Seishi
S
Jinnouchi
Tomio
T
Inoue
Takeshi
T
Iinuma
Takeshi
T
Inoue
Kengo
K
Ito
Hiroshi
H
Iwata
Kimiichi
K
Uno
Shinya
S
Oku
Kazuhiro
K
Oguchi
Eriko
E
Tsukamoto
Rumi
R
Nakashima
Sadahiko
S
Nishizawa
Hiroshi
H
Fukuda
Takeshi
T
Murano
Tsuyoshi
T
Yoshida
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003625:Data Collection; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000145:classification / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed; D055815:Young Adult
D019788:Fluorodeoxyglucose F18