Neslihan Cetin Avci1, Filiz Hatipoglu2, Ahmet Alacacıoglu3, Emine Ebru Bayar2, Gonca Gul Bural4. 1. 1Department of Nuclear Medicine, Umraniye Training and Research Hospital, Umraniye, Istanbul, Turkey. 2. 2Department of Nuclear Medicine, Ataturk Training and Research Hospital, Katip Celebi University, Izmir, Turkey. 3. 3Department of Internal Medicine and Oncology, Ataturk Training and Research Hospital, Katip Celebi University, Izmir, Turkey. 4. 4Department of Nuclear Medicine, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
Abstract
PURPOSE: To compare the performance of fluorine-18 fluorodeoxyglucose positron emission tomography and computed tomography (FDG PET/CT) with conventional imaging methods (CIM), including computed tomography (CT), magnetic resonance imaging (MRI), and mammography (MMG) in cancer of unknown primary (CUP). METHODS: A total of 36 patients with CUP, who referred to our clinic for a FDG PET/CT scan, were enrolled in this study. Thirty of the patients were also examined through either diagnostic CT/MRI and/or MMG. The diagnostic performance of both methods for the primary cancer location was analyzed. The results of FDG PET/CT and CIM were compared based on the standard reference of the histopathology and/or clinical and laboratory follow-up. RESULTS: The primary cancer locations were detected in 24 patients (66.6%, 24/36) by FDG PET/CT, whereas CIM identified the locations in 16 patients (53.3%, 16/30). Sensitivity, specificity, PPV, NPV, and accuracy rates of the detection of the primary tumor localizations were as follows: 83, 70, 89, 58, and 79% for FDG PET/CT; 70, 62, 84, 42, and 68% for CIM, respectively. There was no statistical significance between modalities regarding any of the categories in 30 patients. CONCLUSION: FDG PET/CT detected the primary tumors of the patients with CUP more than CIM did. However, the difference between them was not found to be statistically significant. It may be considered that FDG PET/CT scan can be performed as a first-line tool in the initial diagnosis of the patients with CUP and to add radiodiagnostic imaging in selective cases. We conclude that if the first-line examination of a CUP patient has been already performed by a CIM and the result was negative or inconclusive, FDG PET/CT can be considered to avoid unnecessary imaging procedures.
PURPOSE: To compare the performance of fluorine-18 fluorodeoxyglucose positron emission tomography and computed tomography (FDG PET/CT) with conventional imaging methods (CIM), including computed tomography (CT), magnetic resonance imaging (MRI), and mammography (MMG) in cancer of unknown primary (CUP). METHODS: A total of 36 patients with CUP, who referred to our clinic for a FDG PET/CT scan, were enrolled in this study. Thirty of the patients were also examined through either diagnostic CT/MRI and/or MMG. The diagnostic performance of both methods for the primary cancer location was analyzed. The results of FDG PET/CT and CIM were compared based on the standard reference of the histopathology and/or clinical and laboratory follow-up. RESULTS: The primary cancer locations were detected in 24 patients (66.6%, 24/36) by FDG PET/CT, whereas CIM identified the locations in 16 patients (53.3%, 16/30). Sensitivity, specificity, PPV, NPV, and accuracy rates of the detection of the primary tumor localizations were as follows: 83, 70, 89, 58, and 79% for FDG PET/CT; 70, 62, 84, 42, and 68% for CIM, respectively. There was no statistical significance between modalities regarding any of the categories in 30 patients. CONCLUSION: FDG PET/CT detected the primary tumors of the patients with CUP more than CIM did. However, the difference between them was not found to be statistically significant. It may be considered that FDG PET/CT scan can be performed as a first-line tool in the initial diagnosis of the patients with CUP and to add radiodiagnostic imaging in selective cases. We conclude that if the first-line examination of a CUP patient has been already performed by a CIM and the result was negative or inconclusive, FDG PET/CT can be considered to avoid unnecessary imaging procedures.
Entities:
Keywords:
CT; Cancer of unknown primary origin; FDG PET/CT; MRI; Oncology
Authors: Anne Kirstine H Møller; Annika Loft; Anne K Berthelsen; Karen D Pedersen; Jesper Graff; Charlotte B Christensen; Junia C Costa; Lene T Skovgaard; Katharina Perell; Bodil L Petersen; Gedske Daugaard Journal: Oncologist Date: 2012-06-18
Authors: Gerald Antoch; Florian M Vogt; Lutz S Freudenberg; Fridun Nazaradeh; Susanne C Goehde; Jörg Barkhausen; Gerlinde Dahmen; Andreas Bockisch; Jörg F Debatin; Stefan G Ruehm Journal: JAMA Date: 2003-12-24 Impact factor: 56.272