title: Detection of colorectal cancer and adenomas by FDG-PET cancer screening program: results based on a nationwide Japanese survey.
abstract: OBJECTIVE
  The aim of this study was to analyze the detection rate for CRC and adenomas for asymptomatic subjects in Japan by FDG-PET cancer screening program carried out between 2006 and 2009.
  
  
  METHODS
  The "FDG-PET cancer screening program" included both PET and positron emission tomography with computed tomography (PET/CT) with or without other screening tests. A total of 154,783 asymptomatic subjects underwent FDG-PET cancer screening program; we analyzed the 1,808 cases with findings from any detection method that indicated suspected CRC.
  
  
  RESULTS
  Among the 1,808 cases, the number of cases verified as CRC and adenoma was 394 and 679, respectively. The sensitivity and positive predictive value (PPV) of FDG-PET were 86.0 and 31.7% for CRC, and 63.6 and 63.8% for CRC and adenoma. The sensitivity and PPV of fecal occult blood test (FOBT) for CRC were lower than those of FDG-PET, but higher for adenoma. Therefore, FDG-PET and FOBT were complementary for screening for CRC, and CRC and adenoma. The majority of CRC detected by the FDG-PET imaging was UICC stage 0 or I, however, detection of smaller or less invasive cancer was limited.
  
  
  CONCLUSIONS
  The FDG-PET screening program in Japan has detected CRC at an early stage and adenomas as premalignant lesions. A combination of FDG-PET and FOBT yields the best results if the intent is to detect either CRC or adenoma. However, it is absolutely clear that an FDG-PET cancer screening program cannot detect all colon lesions.
authors.affiliation: Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan, ryogominamimoto@yahoo.co.jp.
authors.forename: Ryogo
authors.initials: R
authors.lastname: Minamimoto
authors.forename: Michio
authors.initials: M
authors.lastname: Senda
authors.forename: Seishi
authors.initials: S
authors.lastname: Jinnouchi
authors.forename: Takashi
authors.initials: T
authors.lastname: Terauchi
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Yoshida
authors.forename: Tomio
authors.initials: T
authors.lastname: Inoue
mesh_terms: D000236:Adenoma / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058070:Asymptomatic Diseases; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D003625:Data Collection; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D019788:Fluorodeoxyglucose F18