Haoping Xu1, Miao Zhang, Ge Zhai, Biao Li. 1. Department of Nuclear Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Rui Jin Er Road, 200025, Shanghai, People's Republic of China.
Abstract
PURPOSE: This retrospective study evaluated the diagnostic value of integrated whole-body (18)F-fluorodeoxyglucose positron-emission tomography and computed tomography ((18)F-FDG-PET/CT) in early detection of second primary malignancies in cancer patients. MATERIALS AND METHODS: From June 2007 to October 2008, 677 cancer patients who had undergone a whole-body (18)F-FDG-PET/CT imaging for the purpose of initial tumor work-up were included in this study. We retrospectively analyzed the follow-up results of patients with newly detected lesions presented on the (18)F-FDG-PET/CT images, which had not been previously detected by other modalities. We diagnosed suspected second primary malignancies by considering PET/CT images and clinical information as well. With the pathological results as the golden standard and complementary clinical follow-up investigations, the sensitivity and the positive-predictive value (PPV) of diagnosis of a second primary malignancy were calculated. RESULTS: We retrospectively analyzed the follow-up results of 338 patients with newly detected lesions. Twenty-one patients were finally diagnosed with second primary malignancies. In addition, the second primary malignancies of 17 patients were diagnosed at an early stage (P = 0.007). Thirteen patients were without any related symptoms which are indicative of second primary malignancies (P = 0.38). The median Karnofsky performance status scale of these patients in the last follow-up study was 80 points. The sensitivity of (18)F-FDG-PET/CT in detecting a second primary malignancy was 95.24%, the PPV was 74.07%, which was much higher than the PPV of diagnosing with no clinical information. CONCLUSION: (18)F-FDG-PET/CT is a useful tool in detecting second primary malignancies in an early stage and can improve the therapeutic effects experienced by the patients.
PURPOSE: This retrospective study evaluated the diagnostic value of integrated whole-body (18)F-fluorodeoxyglucose positron-emission tomography and computed tomography ((18)F-FDG-PET/CT) in early detection of second primary malignancies in cancerpatients. MATERIALS AND METHODS: From June 2007 to October 2008, 677 cancerpatients who had undergone a whole-body (18)F-FDG-PET/CT imaging for the purpose of initial tumor work-up were included in this study. We retrospectively analyzed the follow-up results of patients with newly detected lesions presented on the (18)F-FDG-PET/CT images, which had not been previously detected by other modalities. We diagnosed suspected second primary malignancies by considering PET/CT images and clinical information as well. With the pathological results as the golden standard and complementary clinical follow-up investigations, the sensitivity and the positive-predictive value (PPV) of diagnosis of a second primary malignancy were calculated. RESULTS: We retrospectively analyzed the follow-up results of 338 patients with newly detected lesions. Twenty-one patients were finally diagnosed with second primary malignancies. In addition, the second primary malignancies of 17 patients were diagnosed at an early stage (P = 0.007). Thirteen patients were without any related symptoms which are indicative of second primary malignancies (P = 0.38). The median Karnofsky performance status scale of these patients in the last follow-up study was 80 points. The sensitivity of (18)F-FDG-PET/CT in detecting a second primary malignancy was 95.24%, the PPV was 74.07%, which was much higher than the PPV of diagnosing with no clinical information. CONCLUSION: (18)F-FDG-PET/CT is a useful tool in detecting second primary malignancies in an early stage and can improve the therapeutic effects experienced by the patients.
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