Nucl Med Mol Imaging.  2009 Dec;43(6):526-534.

Detection of Cancer with PET and PET/CT in Asymptomatic Volunteers

Affiliations
  • 1Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. yh38.choi@samsung.com
  • 2Department of Medicine, The Graduate School of Yonsei University, Seoul, Korea.
  • 3Department of Obstetrics and Gynecology, Kangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 4Department of Family Medicine, Kangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 5Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

PURPOSE
We retrospectively investigated the diagnostic performance of (18)F-fluorodeoxyglucose positron emission tomography (PET) and PET/CT for cancer detection in asymptomatic health-check examinees.
MATERIALS AND METHODS
This study consisted of 5091 PET or PET/CT conducted as part of annual health examination at one hospital from March 1998 to February 2008. To find the incidence of cancers, medical records of the subjects were thoroughly reviewed for a follow-up period of one year. The patterns of formal readings of PET and PET/CT were analyzed to assess the sensitivity and specificity for cancer detection. The histopathology and stage of the cancers were evaluated in relation to the results of PET.
RESULTS
Eighty-six cancers (1.7%) were diagnosed within one year after PET or PET/CT. When PET and PET/CT results were combined, the sensitivity was 48.8% and specificity was 81.1% for cancer detection. PET only had a sensitivity of 46.2% and a specificity of 81.4%, and PET/CT only had a sensitivity of 75.0% and a specificity of 78.5% respectively. There were no significant differences in cancer site, stage and histopathology between PET positive and PET negative cancers. In 19.3% of formal readings of PET and PET/CT, further evaluation to exclude malignancy or significant disease was recommended. Head and neck area and upper gastrointestinal tract were commonly recommended sites for further evaluation.
CONCLUSIONS
PET and PET/CT showed moderate performance for detecting cancers in asymptomatic adults in this study. More experience and further investigation are needed to overcome limitations of PET and PET/CT for cancer screening.

Keyword

Early detection of cancer; positron emission tomography; sensitivity and specificity

MeSH Terms

Adult
Early Detection of Cancer
Follow-Up Studies
Head
Humans
Incidence
Medical Records
Neck
Positron-Emission Tomography
Reading
Retrospective Studies
Sensitivity and Specificity
Upper Gastrointestinal Tract
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