Abstract
Objective
This study was performed to evaluate the clinical value of 18F-fluorodeoxyglucose (FDG) positron-emission tomography (PET)/computed tomography (CT) for cancer screening in Korean asymptomatic people.
Methods
Between February 2004 and December 2006, 1,587 asymptomatic individuals underwent FDG PET/CT as part of a cancer screening program with some other diagnostic tests at the healthcare center of our hospital. After excluding patients with a history of malignant tumor, 1,336 subjects were enrolled. All PET/CT images were visually analyzed. In subjects showing positive findings for PET/CT or other screening tests, further diagnostic tests and pathological confirmation were performed.
Results
Of the 1,336 subjects, malignant tumors were found in 16 participants (1.2%, thyroid cancer: 9, lung cancer: 2, stomach cancer: 2, and others: 4). There were 47 cases (3.6%) of positive PET/CT findings—11 cases were true positive (thyroid cancer: 8, lung cancer: 1, renal cancer: 1, and invasive thymoma), and 36 false positive, and five cases were false negative. The overall detection rate of PET/CT was 0.8%, and the sensitivity, specificity, positive-predictive value, and negative-predictive value of PET/CT were 68.8, 97.2, 23.4, and 99.6%, respectively.
Conclusions
Fluorodeoxyglucose positron-emission tomography has the potential to detect various kinds of malignant tumors in cancer screening test, and the overall detection rate of PET/CT was 0.8%. FDG PET/CT can be a useful cancer screening modality with the selection of high-risk group and appropriate combination with other screening modalities.
Similar content being viewed by others
References
Barratt A, Mannes P, Irwig L, Trevena L, Craig J, Rychetnik L. Cancer screening. J Epidemiol Community Health. 2002;56:899–902.
Rohren EM, Turkington TG, Coleman RE. Clinical application of PET in oncology. Radiology. 2004;231:305–32.
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.
Chen YK, Ding HJ, Su CT, Shen YY, Chen LK, Liao AC, et al. Application of PET and PET/CT imaging for cancer screening. Anticancer Res. 2004;24:4103–8.
Ghotbi N, Iwanaga M, Ohtsuru A, Ogawa Y, Yamashita S. Cancer screening with whole-body PET/CT for healthy asymptomatic people in Japan: re-evaluation of its test validity and radiation exposure. Asian Pac J Cancer Prev. 2007;8:93–7.
Charron M, Beyer T, Bohnen NN, Kinahan PE, Dachille M, Jerin J, et al. Image analysis in patients with cancer studied with a combined PET and CT scanner. Clin Nucl Med. 2000;25:905–10.
Bar-Shalom R, Yefremov N, Guralnik L, Gaitini D, Frenkel A, Kuten A, et al. Clinical performance of PET/CT in the evaluation of cancer: additional value for diagnostic imaging and patient management. J Nucl Med. 2003;44:1200–9.
Shen YY, Su CT, Chen GJ, Chen YK, Liao AC, Tsai FS. The value of F-18 fluorodeoxyglucose positron emission tomography with the additional help of tumor markers in cancer screening. Neoplasma. 2003;50:217–21.
Kojima S, Zhou B, Teramukai S, Hara A, Kosaka N, Matsuo Y, et al. Cancer screening of healthy volunteers using whole-body F-18 FDG-PET scans: the Nishidai clinic study. Eur J Cancer. 2007;43:1842–8.
Ko DH, Choi JY, Song Y, Lee SJ, Kim YH, Lee K, et al. The usefulness of 18F-FDG PET as a cancer screening test. Nucl Med Mol Imaging. 2008;42:444–50.
Minamimoto R, Senda M, Uno K, Jinnouchi S, Iinuma S, 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.
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: a preliminary report. Ann Nucl Med. 2008;22:379–85.
Cook GJ. Pitfalls in PET/CT interpretation. Q J Nucl Med Mol Imaging. 2007;51:235–43.
Yasuada 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.
Stahl A, Ott K, Weber WA, Becker K, Link T, Siewert JR, et al. FDG PET imaging of locally advanced gastric carcinomas: correlation with endoscopic and histopathologic findings. Eur J Nucl Med Mol Imaging. 2003;30:288–95.
Higashi K, Ueda Y, Seki H, Oguchi M, Nambu Y, Ueda Y, et al. Flurine-18-FDG imaging is negative in bronchioalveolar lung carcinoma. J Nucl Med. 1998;39:1016–20.
WHO Fact sheets. Available at http://www.who.int/mediacentre/factsheets/fs297/en/index.html.
Brix G, Lechel U, Glatting G, Ziegler SI, Münzing W, Müller SP, et al. Radiation exposure of patients undergoing whole-body dual-modality 18F-FDG PET/CT examinations. J Nucl Med. 2005;46:608–13.
Deloar HM, Fujiwara T, Shidahara M, Nakamura T, Watabe H, Narita Y, et al. Estimation of absorbed dose for 2-[F-18] fluoro-2-deoxy-d-glucose using whole-body positron emission tomography and magnetic resonance imaging. Eur J Nucl Med. 1998;25:565–74.
Recommendations of the International Commission on Radiological Protection. ICRP publication no. 60. Oxford: Pergamon; 1991.
Weckesser M, Schober O. Is whole-body FDG-PET valuable for health screening? Against. Eur J Nucl Med Mol Imaging. 2005;32:342–3.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lee, J.W., Kang, K.W., Paeng, J.C. et al. Cancer screening using 18F-FDG PET/CT in Korean asymptomatic volunteers: a preliminary report. Ann Nucl Med 23, 685–691 (2009). https://doi.org/10.1007/s12149-009-0291-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12149-009-0291-z