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Ten-year prospective evaluation of whole-body cancer screening with multiple modalities including [18F]fluorodeoxyglucose positron emission tomography in a healthy population

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Abstract

Purpose

To prospectively evaluate the value of whole-body cancer screening with multiple modalities including FDG-PET in a healthy population.

Methods

The study was conducted in 1197 healthy individuals aged ≥ 35 years at enrollment between August 2003 and July 2004. All participants were scheduled to receive annual whole-body cancer screening five times (screening period) with subsequent long-term follow-up (follow-up period). The endpoints of the study were definitive cancer diagnosis, cancer-related death, and all-cause death.

Results

The follow-up rate was 99.8% for the screening period and 96.2% for the follow-up period. Forty-five cancers were confirmed during the screening period (August 2003 to July 2009), and 37 of the 45 were detected by the screening. Fourteen of the 45 were PET positive. Sixteen, 5, 4, 9 and 11 cancers were confirmed after the first, the second, the third, the fourth, and the fifth (took 2 years) screening, respectively. Eight participants died, of whom five died of cancer. The rate of cancer incidence (per 100,000) of 628.7 (95% confidence interval [CI] 445.0–812.4) was significantly high, and the rates of cancer mortality and all-cause mortality of 69.9 (95% CI 8.6–131.1) and 111.8 (95% CI 34.3–189.2), respectively, were significantly low, compared with the corresponding rates of 379.3, 138.2 and 354.2, respectively, in the age-rank- and sex-matched general population. During the follow-up period (August 2009 to July 2013), 37 cancers were confirmed and 30 of the 37 were detected. Seven participants died, of whom three died of cancer. The rate of cancer incidence was 809.6 (95% CI 548.7–1070.5). The rates of cancer mortality and all-cause mortality of 65.6 (95% CI 0–139.9) and 153.2 (95% CI 39.7–266.6), respectively, were significantly low compared with 190.1 and 462.3, respectively, in the general population.

Conclusion

Cancer detection by PET alone was limited. While the high cancer incidence was attributed to the extensive screening, the low cancer and all-cause mortality may indicate the potential value of this type of cancer screening. Cancer incidence increases with aging and it has been shown that continuous screening may reduce the risk caused by the cancer progression.

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References

  1. Ministry of Health, Labour and Welfare, Japan. Vital statistics in Japan. 2018. https://ganjoho.jp/data/reg_stat/statistics/brochure/2018/cancer_statistics_2018.pdf. Accessed 22 Sept 2019.

  2. National Lung Screening Trial Research Team, Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, Fagerstrom RM, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365:395–409. https://doi.org/10.1056/NEJMoa1102873.

    Article  Google Scholar 

  3. Ohuchi N, Suzuki A, Sobue T, Kawai M, Yamamoto S, Zheng YF, et al. Sensitivity and specificity of mammography and adjunctive ultrasonography to screen for breast cancer in the Japan Strategic Anti-cancer Randomized Trial (J-START): a randomized controlled trial. Lancet. 2016;387:341–8. https://doi.org/10.1016/S0140-6736(15)00774-6.

    Article  PubMed  Google Scholar 

  4. Regge D, Iussich G, Segnan N, Correale L, Hassan C, Arrigoni A, et al. Comparing CT colonography and flexible sigmoidoscopy: a randomised trial within a population-based screening programme. Gut. 2017;66:1434–40. https://doi.org/10.1136/gutjnl-2015-311278.

    Article  PubMed  Google Scholar 

  5. Yasuda S, Ide M, Fujii H, Nakahara T, Mochizuki Y, Takahashi W, et al. Application of positron emission tomography imaging to cancer screening. Br J Cancer. 2000;83:1607–11. https://doi.org/10.1054/bjoc.2000.1496.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Kojima S, Zhou B, Teramukai S, Hara A, Kosaka N, Matsuo Y, et al. Cancer screening of healthy volunteers using whole-body 18F-FDG-PET scans: the Nishidai clinic study. Eur J Cancer. 2007;43:1842–8. https://doi.org/10.1016/j.ejca.2007.05.010.

    Article  PubMed  Google Scholar 

  7. Minamimoto R, Senda M, Uno K, Jinnouchi S, Iinuma T, Ito K, et al. Performance profile of FDG-PET and PET/CT for cancer screening on the basis of a Japanese Nationwide Survey. Ann Nucl Med. 2007;21:481–98. https://doi.org/10.1007/s12149-007-0061-8.

    Article  PubMed  Google Scholar 

  8. Ono K, Ochiai R, Yoshida T, Kitagawa M, Omagari J, Kobayashi H, et al. The detection rates and tumor clinical/pathological stages of whole-body FDG-PET cancer screening. Ann Nucl Med. 2007;21:65–72.

    Article  Google Scholar 

  9. Terauchi T, Murano T, Daisaki H, Kanou D, Shoda H, Kakinuma R, et al. Evaluation of whole-body cancer screening using 18F–2-deoxy-2-fluoro-d-glucose positron emission tomography: preliminary report. Ann Nucl Med. 2008;22:379–85. https://doi.org/10.1007/s12149-008-0130-7.

    Article  PubMed  Google Scholar 

  10. Nishizawa S, Kojima S, Teramukai S, Inubushi M, Kodama H, Maeda Y, et al. Prospective evaluation of whole-body cancer screening with multiple modalities including [18F]fluorodeoxyglucose positron emission tomography in a healthy population: a preliminary report. J Clin Oncol. 2009;27:1767–73. https://doi.org/10.1200/JCO.2008.18.2238.

    Article  PubMed  Google Scholar 

  11. Minamimoto R, Senda M, Terauchi T, Jinnouchi S, Inoue T, Iinuma T, et al. Analysis of various malignant neoplasms detected by FDG-PET cancer screening program: based on a Japanese Nationwide survey. Ann Nucl Med. 2011;25:45–54. https://doi.org/10.1007/s12149-010-0428-0.

    Article  PubMed  Google Scholar 

  12. Nurano T, Minamimoto R, Senda M, Uno K, Jinnouchi S, Fukuda H, et al. Radiation exposure and risk-benefit analysis in cancer screening using FDG-PET: results of Japanese nationwide survey. Ann Nucl Med. 2011;25:657–66. https://doi.org/10.1007/s12149-011-0511-1.

    Article  Google Scholar 

  13. Minamimoto R, Senda M, Jinnouchi S, Terauchi T, Yoshida T, Murano T, et al. The current status of an FDG-PET cancer screening program in Japan, based on a 4-year (2006–2009) nationwide survey. Ann Nucl Med. 2013;27:46–57. https://doi.org/10.1007/s12149-012-0660-x.

    Article  PubMed  Google Scholar 

  14. Isotope news [in Japanese]. 2019. https://www.jrias.or.jp/books/catalog.html, recent document in https://www.jrias.or.jp/books/pdf/201802_SHIRYO_KAMIYA.pdf. Accessed 22 Sept 2019.

  15. Watanabe M, Shimizu K, Omura T, Sato N, Takahashi M, Kosugi T, et al. A high-throughput whole-body PET scanner using flat panel PS-PMTs. IEEE Trans Nucl Sci. 2004;51:796–800.

    Article  Google Scholar 

  16. Tanaka E, Kudo H. Subset-dependent relaxation in block-iterative algorithms for image reconstruction in emission tomography. Phys Med Biol. 2003;48:1405–22.

    Article  Google Scholar 

  17. Minamimoto R, Senada M, Jinnouchi S, Yoshida T, Nakashima R, Nishizawa S, et al. Assessment of diagnostic criteria for FDG-PET cancer screening program according to the interpretation of FDG-PET and combined examination [in Japanese]. Kaku Igaku. 2009;46:73–93.

    PubMed  Google Scholar 

  18. National Cancer Center. Cancer Statistics in Japan [in Japanese]. 2019. https://ganjoho.jp/reg_stat/statistics/dl/index.html. Accessed 22 Sept 2019.

  19. Ministry of Health, Labour and Welfare, Japan. Vital statistics in Japan [in Japanese]. 2019. https://www.mhlw.go.jp/toukei/list/81-1a.html. Accessed 22 Sept 2019.

  20. Nishizawa S, Okada H. PET cancer screening with multiple imaging modalities: current status and prospects (in Japanese). Jpn J Clin Radiol. 2017;62:645–53.

    Google Scholar 

  21. Welch HG, Black WC. Overdiagnosis in cancer. J Natl Cancer Inst. 2010;102:605–13. https://doi.org/10.1093/jnci/djq099.

    Article  PubMed  Google Scholar 

  22. Nishizawa S, Kodama H, Maeda Y, Okada H. Whole-body cancer screening with multiple modalities including FDG-PET: a summary of 5 year’s practice for general asymptomatic individuals. Eur J Nucl Med Mol Imaging. 2009;36(suppl 2):S356. https://doi.org/10.1007/s00259-011-1910-1.

    Article  Google Scholar 

  23. Cherry SR, Jones T, Karp JS, Qi J, Moses WW, Badawi RD. Total-body PET: maximizing sensitivity to create new opportunities for clinical research and patient care. J Nucl Med. 2018;59:3–12. https://doi.org/10.2967/jnumed.116.184028.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Zhang X, Xie Z, Berg E, Judenhofer MS, Liu W, Xu T, et al. Total-body dynamic reconstruction and parametric imaging on the uEXPLORER. J Nucl Med. 2019. https://doi.org/10.2967/jnumed.119.230565(Epub ahead of print).

    Article  PubMed  PubMed Central  Google Scholar 

  25. Zhang H, Wang J, Zeng D, Tao X, Ma J. Regularization strategies in statistical image reconstruction of low-dose x-ray CT: a review. Med Phys. 2018;45:e886–e907. https://doi.org/10.1002/mp.13123.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

We thank all the collaborated staff of this research in the Hamamatsu Medical Imaging Center, Hamamatsu Photonics KK and the Photonics Group Health Insurance Society.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Hamamatsu Medical Imaging Center, Hamamatsu Medical Photonics Foundation, 5000 Hirakuchi, Hamakita-ku, Hamamatsu, Shizuoka, 434-0041, Japan

    Sadahiko Nishizawa, Hiroyuki Okada & Tatsuo Torizuka

  2. Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation, 1-5-4 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan

    Shinsuke Kojima & Masanori Fukushima

  3. Department of Business Accelerator, Global Strategic Challenge Center, Hamamatsu Photonics K.K, 5000 Hirakuchi, Hamakita-ku, Hamamatsu, Shizuoka, 434-8601, Japan

    Hiroyuki Okada & Tomomi Shinke

  4. Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan

    Satoshi Teramukai

Authors
  1. Sadahiko Nishizawa
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  2. Shinsuke Kojima
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Correspondence to Sadahiko Nishizawa.

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Nishizawa, S., Kojima, S., Okada, H. et al. Ten-year prospective evaluation of whole-body cancer screening with multiple modalities including [18F]fluorodeoxyglucose positron emission tomography in a healthy population. Ann Nucl Med 34, 358–368 (2020). https://doi.org/10.1007/s12149-020-01456-9

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