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Published in: European Journal of Nuclear Medicine and Molecular Imaging 3/2010

Open Access 01-03-2010 | Review Article

FDG PET/CT in carcinoma of unknown primary

Authors: Thomas C. Kwee, Sandip Basu, Gang Cheng, Abass Alavi

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 3/2010

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Abstract

Carcinoma of unknown primary (CUP) is a heterogeneous group of metastatic malignancies in which a primary tumor could not be detected despite thorough diagnostic evaluation. Because of its high sensitivity for the detection of lesions, combined 18F-fluoro-2-deoxyglucose positron emission tomography (FDG PET)/computed tomography (CT) may be an excellent alternative to CT alone and conventional magnetic resonance imaging in detecting the unknown primary tumor. This article will review the use, diagnostic performance, and utility of FDG PET/CT in CUP and will discuss challenges and future considerations in the diagnostic management of CUP.
Literature
1.
2.
go back to reference Haas I, Hoffmann TK, Engers R, Ganzer U. Diagnostic strategies in cervical carcinoma of an unknown primary (CUP). Eur Arch Otorhinolaryngol 2002;259:325–3.CrossRefPubMed Haas I, Hoffmann TK, Engers R, Ganzer U. Diagnostic strategies in cervical carcinoma of an unknown primary (CUP). Eur Arch Otorhinolaryngol 2002;259:325–3.CrossRefPubMed
3.
go back to reference Raber MN, Faintuch J, Abbruzzese JL, Sumrall C, Frost P. Continuous infusion 5-fluorouracil, etoposide and cis-diamminedichloroplatinum in patients with metastatic carcinoma of unknown primary origin. Ann Oncol 1991;2:519–20.PubMed Raber MN, Faintuch J, Abbruzzese JL, Sumrall C, Frost P. Continuous infusion 5-fluorouracil, etoposide and cis-diamminedichloroplatinum in patients with metastatic carcinoma of unknown primary origin. Ann Oncol 1991;2:519–20.PubMed
4.
go back to reference Rege S, Maass A, Chaiken L, Hoh CK, Choi Y, Lufkin R, et al. Use of positron emission tomography with fluorodeoxyglucose in patients with extracranial head and neck cancers. Cancer 1994;73:3047–58.CrossRefPubMed Rege S, Maass A, Chaiken L, Hoh CK, Choi Y, Lufkin R, et al. Use of positron emission tomography with fluorodeoxyglucose in patients with extracranial head and neck cancers. Cancer 1994;73:3047–58.CrossRefPubMed
5.
go back to reference Rohren EM, Turkington TG, Coleman RE. Clinical applications of PET in oncology. Radiology 2004;231:305–32.CrossRefPubMed Rohren EM, Turkington TG, Coleman RE. Clinical applications of PET in oncology. Radiology 2004;231:305–32.CrossRefPubMed
6.
go back to reference Roh JL, Kim JS, Lee JH, Cho KJ, Choi SH, Nam SY, et al. Utility of combined (18)F-fluorodeoxyglucose-positron emission tomography and computed tomography in patients with cervical metastases from unknown primary tumors. Oral Oncol 2009;45:218–24.CrossRefPubMed Roh JL, Kim JS, Lee JH, Cho KJ, Choi SH, Nam SY, et al. Utility of combined (18)F-fluorodeoxyglucose-positron emission tomography and computed tomography in patients with cervical metastases from unknown primary tumors. Oral Oncol 2009;45:218–24.CrossRefPubMed
7.
go back to reference Nassenstein K, Veit-Haibach P, Stergar H, Gutzeit A, Freudenberg L, Kuehl H, et al. Cervical lymph node metastases of unknown origin: primary tumor detection with whole-body positron emission tomography/computed tomography. Acta Radiol 2007;48:1101–8.CrossRef Nassenstein K, Veit-Haibach P, Stergar H, Gutzeit A, Freudenberg L, Kuehl H, et al. Cervical lymph node metastases of unknown origin: primary tumor detection with whole-body positron emission tomography/computed tomography. Acta Radiol 2007;48:1101–8.CrossRef
8.
go back to reference Freudenberg LS, Fischer M, Antoch G, Jentzen W, Gutzeit A, Rosenbaum SJ, et al. Dual modality of 18F-fluorodeoxyglucose-positron emission tomography/computed tomography in patients with cervical carcinoma of unknown primary. Med Princ Pract 2005;14:155–60.CrossRefPubMed Freudenberg LS, Fischer M, Antoch G, Jentzen W, Gutzeit A, Rosenbaum SJ, et al. Dual modality of 18F-fluorodeoxyglucose-positron emission tomography/computed tomography in patients with cervical carcinoma of unknown primary. Med Princ Pract 2005;14:155–60.CrossRefPubMed
9.
go back to reference Gutzeit A, Antoch G, Kühl H, Egelhof T, Fischer M, Hauth E, et al. Unknown primary tumors: detection with dual-modality PET/CT—initial experience. Radiology 2005;234:227–34.CrossRefPubMed Gutzeit A, Antoch G, Kühl H, Egelhof T, Fischer M, Hauth E, et al. Unknown primary tumors: detection with dual-modality PET/CT—initial experience. Radiology 2005;234:227–34.CrossRefPubMed
10.
go back to reference Mawlawi O, Townsend DW. Multimodality imaging: an update on PET/CT technology. Eur J Nucl Med Mol Imaging 2009;36(Suppl 1):S15–29.CrossRefPubMed Mawlawi O, Townsend DW. Multimodality imaging: an update on PET/CT technology. Eur J Nucl Med Mol Imaging 2009;36(Suppl 1):S15–29.CrossRefPubMed
11.
12.
go back to reference Kwee TC, Kwee RM. Combined FDG-PET/CT for the detection of unknown primary tumors: systematic review and meta-analysis. Eur Radiol 2009;19:731–44.CrossRefPubMed Kwee TC, Kwee RM. Combined FDG-PET/CT for the detection of unknown primary tumors: systematic review and meta-analysis. Eur Radiol 2009;19:731–44.CrossRefPubMed
13.
go back to reference Hany TF, Heuberger J, von Schulthess GK. Iatrogenic FDG foci in the lungs: a pitfall of PET image interpretation. Eur Radiol 2003;13:2122–7.CrossRefPubMed Hany TF, Heuberger J, von Schulthess GK. Iatrogenic FDG foci in the lungs: a pitfall of PET image interpretation. Eur Radiol 2003;13:2122–7.CrossRefPubMed
14.
go back to reference El-Haddad G, Alavi A, Mavi A, Bural G, Zhuang H. Normal variants in [18F]-fluorodeoxyglucose PET imaging. Radiol Clin North Am 2004;42:1063–81.CrossRefPubMed El-Haddad G, Alavi A, Mavi A, Bural G, Zhuang H. Normal variants in [18F]-fluorodeoxyglucose PET imaging. Radiol Clin North Am 2004;42:1063–81.CrossRefPubMed
15.
go back to reference Fischbach F, Knollmann F, Griesshaber V, Freund T, Akkol E, Felix R. Detection of pulmonary nodules by multislice computed tomography: improved detection rate with reduced slice thickness. Eur Radiol 2003;13:2378–83.CrossRefPubMed Fischbach F, Knollmann F, Griesshaber V, Freund T, Akkol E, Felix R. Detection of pulmonary nodules by multislice computed tomography: improved detection rate with reduced slice thickness. Eur Radiol 2003;13:2378–83.CrossRefPubMed
16.
go back to reference Al-Brahim N, Ross C, Carter B, Chorneyko K. The value of postmortem examination in cases of metastasis of unknown origin-20-year retrospective data from a tertiary care center. Ann Diagn Pathol 2005;9:77–80.CrossRefPubMed Al-Brahim N, Ross C, Carter B, Chorneyko K. The value of postmortem examination in cases of metastasis of unknown origin-20-year retrospective data from a tertiary care center. Ann Diagn Pathol 2005;9:77–80.CrossRefPubMed
17.
go back to reference Blaszyk H, Hartmann A, Bjornsson J. Cancer of unknown primary: clinicopathologic correlations. APMIS 2003;111:1089–94.CrossRefPubMed Blaszyk H, Hartmann A, Bjornsson J. Cancer of unknown primary: clinicopathologic correlations. APMIS 2003;111:1089–94.CrossRefPubMed
18.
go back to reference Mayordomo JI, Guerra JM, Guijarro C, García-Prats MD, Gómez A, López-Brea M, et al. Neoplasms of unknown primary site: a clinicopathological study of autopsied patients. Tumori 1993;79:321–4.PubMed Mayordomo JI, Guerra JM, Guijarro C, García-Prats MD, Gómez A, López-Brea M, et al. Neoplasms of unknown primary site: a clinicopathological study of autopsied patients. Tumori 1993;79:321–4.PubMed
19.
go back to reference Le Chevalier T, Cvitkovic E, Caille P, Harvey J, Contesso G, Spielmann M, et al. Early metastatic cancer of unknown primary origin at presentation. A clinical study of 302 consecutive autopsied patients. Arch Intern Med 1988;148:2035–9.CrossRefPubMed Le Chevalier T, Cvitkovic E, Caille P, Harvey J, Contesso G, Spielmann M, et al. Early metastatic cancer of unknown primary origin at presentation. A clinical study of 302 consecutive autopsied patients. Arch Intern Med 1988;148:2035–9.CrossRefPubMed
20.
go back to reference Fencl P, Belohlavek O, Skopalova M, Jaruskova M, Kantorova I, Simonova K. Prognostic and diagnostic accuracy of [18F]FDG-PET/CT in 190 patients with carcinoma of unknown primary. Eur J Nucl Med Mol Imaging 2007;34:1783–92.CrossRefPubMed Fencl P, Belohlavek O, Skopalova M, Jaruskova M, Kantorova I, Simonova K. Prognostic and diagnostic accuracy of [18F]FDG-PET/CT in 190 patients with carcinoma of unknown primary. Eur J Nucl Med Mol Imaging 2007;34:1783–92.CrossRefPubMed
21.
go back to reference Ay MR, Zaidi H. Assessment of errors caused by X-ray scatter and use of contrast medium when using CT-based attenuation correction in PET. Eur J Nucl Med Mol Imaging 2006;33:1301–13.CrossRefPubMed Ay MR, Zaidi H. Assessment of errors caused by X-ray scatter and use of contrast medium when using CT-based attenuation correction in PET. Eur J Nucl Med Mol Imaging 2006;33:1301–13.CrossRefPubMed
22.
go back to reference Namasivayam S, Kalra MK, Torres WE, Small WC. Adverse reactions to intravenous iodinated contrast media: a primer for radiologists. Emerg Radiol 2006;12:210–5.CrossRefPubMed Namasivayam S, Kalra MK, Torres WE, Small WC. Adverse reactions to intravenous iodinated contrast media: a primer for radiologists. Emerg Radiol 2006;12:210–5.CrossRefPubMed
23.
go back to reference Hainsworth JD, Greco FA. Treatment of patients with cancer of an unknown primary site. N Engl J Med 1993;329:257–63.CrossRefPubMed Hainsworth JD, Greco FA. Treatment of patients with cancer of an unknown primary site. N Engl J Med 1993;329:257–63.CrossRefPubMed
24.
go back to reference Fukui MB, Blodgett TM, Snyderman CH, Johnson JJ, Myers EN, Townsend DW, et al. Combined PET-CT in the head and neck: part 2. Diagnostic uses and pitfalls of oncologic imaging. Radiographics 2005;25:913–30.CrossRefPubMed Fukui MB, Blodgett TM, Snyderman CH, Johnson JJ, Myers EN, Townsend DW, et al. Combined PET-CT in the head and neck: part 2. Diagnostic uses and pitfalls of oncologic imaging. Radiographics 2005;25:913–30.CrossRefPubMed
25.
go back to reference Metser U, Even-Sapir E. Increased (18)F-fluorodeoxyglucose uptake in benign, nonphysiologic lesions found on whole-body positron emission tomography/computed tomography (PET/CT): accumulated data from four years of experience with PET/CT. Semin Nucl Med 2007;37:206–22.CrossRefPubMed Metser U, Even-Sapir E. Increased (18)F-fluorodeoxyglucose uptake in benign, nonphysiologic lesions found on whole-body positron emission tomography/computed tomography (PET/CT): accumulated data from four years of experience with PET/CT. Semin Nucl Med 2007;37:206–22.CrossRefPubMed
26.
go back to reference Shim SS, Lee KS, Kim BT, Choi JY, Chung MJ, Lee EJ. Focal parenchymal lung lesions showing a potential of false-positive and false-negative interpretations on integrated PET/CT. AJR Am J Roentgenol 2006;186:639–48.CrossRefPubMed Shim SS, Lee KS, Kim BT, Choi JY, Chung MJ, Lee EJ. Focal parenchymal lung lesions showing a potential of false-positive and false-negative interpretations on integrated PET/CT. AJR Am J Roentgenol 2006;186:639–48.CrossRefPubMed
27.
28.
go back to reference Pentheroudakis G, Briasoulis E, Pavlidis N. Cancer of unknown primary site: missing primary or missing biology? Oncologist 2007;12:418–25.CrossRefPubMed Pentheroudakis G, Briasoulis E, Pavlidis N. Cancer of unknown primary site: missing primary or missing biology? Oncologist 2007;12:418–25.CrossRefPubMed
29.
go back to reference van de Wouw AJ, Jansen RL, Speel EJ, Hillen HF. The unknown biology of the unknown primary tumour: a literature review. Ann Oncol 2003;14:191–6.CrossRefPubMed van de Wouw AJ, Jansen RL, Speel EJ, Hillen HF. The unknown biology of the unknown primary tumour: a literature review. Ann Oncol 2003;14:191–6.CrossRefPubMed
30.
go back to reference Sève P, Billotey C, Broussolle C, Dumontet C, Mackey JR. The role of 2-deoxy-2-[F-18]fluoro-D-glucose positron emission tomography in disseminated carcinoma of unknown primary site. Cancer 2007;109:292–9.CrossRefPubMed Sève P, Billotey C, Broussolle C, Dumontet C, Mackey JR. The role of 2-deoxy-2-[F-18]fluoro-D-glucose positron emission tomography in disseminated carcinoma of unknown primary site. Cancer 2007;109:292–9.CrossRefPubMed
31.
go back to reference Rusthoven KE, Koshy M, Paulino AC. The role of fluorodeoxyglucose positron emission tomography in cervical lymph node metastases from an unknown primary tumor. Cancer 2004;101:2641–9.CrossRefPubMed Rusthoven KE, Koshy M, Paulino AC. The role of fluorodeoxyglucose positron emission tomography in cervical lymph node metastases from an unknown primary tumor. Cancer 2004;101:2641–9.CrossRefPubMed
32.
go back to reference Delgado-Bolton RC, Fernández-Pérez C, González-Maté A, Carreras JL. Meta-analysis of the performance of 18F-FDG PET in primary tumor detection in unknown primary tumors. J Nucl Med 2003;44:1301–14.PubMed Delgado-Bolton RC, Fernández-Pérez C, González-Maté A, Carreras JL. Meta-analysis of the performance of 18F-FDG PET in primary tumor detection in unknown primary tumors. J Nucl Med 2003;44:1301–14.PubMed
33.
go back to reference Werner JA, Dünne AA, Myers JN. Functional anatomy of the lymphatic drainage system of the upper aerodigestive tract and its role in metastasis of squamous cell carcinoma. Head Neck 2003;25:322–32.CrossRefPubMed Werner JA, Dünne AA, Myers JN. Functional anatomy of the lymphatic drainage system of the upper aerodigestive tract and its role in metastasis of squamous cell carcinoma. Head Neck 2003;25:322–32.CrossRefPubMed
34.
go back to reference Rosen EL, Eubank WB, Mankoff DA. FDG PET, PET/CT, and breast cancer imaging. Radiographics 2007;27(Suppl 1):S215–29.CrossRefPubMed Rosen EL, Eubank WB, Mankoff DA. FDG PET, PET/CT, and breast cancer imaging. Radiographics 2007;27(Suppl 1):S215–29.CrossRefPubMed
35.
go back to reference Buchanan CL, Morris EA, Dorn PL, Borgen PI, Van Zee KJ. Utility of breast magnetic resonance imaging in patients with occult primary breast cancer. Ann Surg Oncol 2005;12:1045–53.CrossRefPubMed Buchanan CL, Morris EA, Dorn PL, Borgen PI, Van Zee KJ. Utility of breast magnetic resonance imaging in patients with occult primary breast cancer. Ann Surg Oncol 2005;12:1045–53.CrossRefPubMed
36.
go back to reference Schorn C, Fischer U, Luftner-Nagel S, Westerhof JP, Grabbe E. MRI of the breast in patients with metastatic disease of unknown primary. Eur Radiol 1999;9:470–3.CrossRefPubMed Schorn C, Fischer U, Luftner-Nagel S, Westerhof JP, Grabbe E. MRI of the breast in patients with metastatic disease of unknown primary. Eur Radiol 1999;9:470–3.CrossRefPubMed
37.
go back to reference Kaya AO, Coskun U, Unlu M, Akdemir UO, Ozdemir NY, Zengin N, et al. Whole body 18F-FDG PET/CT imaging in the detection of primary tumours in patients with a metastatic carcinoma of unknown origin. Asian Pac J Cancer Prev 2008;9:683–6.PubMed Kaya AO, Coskun U, Unlu M, Akdemir UO, Ozdemir NY, Zengin N, et al. Whole body 18F-FDG PET/CT imaging in the detection of primary tumours in patients with a metastatic carcinoma of unknown origin. Asian Pac J Cancer Prev 2008;9:683–6.PubMed
38.
go back to reference Gladish GW, Choe DH, Marom EM, Sabloff BS, Broemeling LD, Munden RF. Incidental pulmonary emboli in oncology patients: prevalence, CT evaluation, and natural history. Radiology 2006;240:246–55.CrossRefPubMed Gladish GW, Choe DH, Marom EM, Sabloff BS, Broemeling LD, Munden RF. Incidental pulmonary emboli in oncology patients: prevalence, CT evaluation, and natural history. Radiology 2006;240:246–55.CrossRefPubMed
39.
go back to reference Schapira DV, Jarrett AR. The need to consider survival, outcome, and expense when evaluating and treating patients with unknown primary carcinoma. Arch Intern Med 1995;155:2050–4.CrossRefPubMed Schapira DV, Jarrett AR. The need to consider survival, outcome, and expense when evaluating and treating patients with unknown primary carcinoma. Arch Intern Med 1995;155:2050–4.CrossRefPubMed
40.
go back to reference Basu S, Alavi A. FDG-PET in the clinical management of carcinoma of unknown primary with metastatic cervical lymphadenopathy: shifting gears from detecting the primary to planning therapeutic strategies. Eur J Nucl Med Mol Imaging 2007;34:427–8.CrossRefPubMed Basu S, Alavi A. FDG-PET in the clinical management of carcinoma of unknown primary with metastatic cervical lymphadenopathy: shifting gears from detecting the primary to planning therapeutic strategies. Eur J Nucl Med Mol Imaging 2007;34:427–8.CrossRefPubMed
41.
go back to reference Fletcher JW, Djulbegovic B, Soares HP, Siegel BA, Lowe VJ, Lyman GH, et al. Recommendations on the use of 18F-FDG PET in oncology. J Nucl Med 2008;49:480–508.CrossRefPubMed Fletcher JW, Djulbegovic B, Soares HP, Siegel BA, Lowe VJ, Lyman GH, et al. Recommendations on the use of 18F-FDG PET in oncology. J Nucl Med 2008;49:480–508.CrossRefPubMed
42.
go back to reference Hillner BE, Siegel BA, Liu D, Shields AF, Gareen IF, Hanna L, et al. Impact of positron emission tomography/computed tomography and positron emission tomography (PET) alone on expected management of patients with cancer: initial results from the National Oncologic PET Registry. J Clin Oncol 2008;26:2155–61.CrossRefPubMed Hillner BE, Siegel BA, Liu D, Shields AF, Gareen IF, Hanna L, et al. Impact of positron emission tomography/computed tomography and positron emission tomography (PET) alone on expected management of patients with cancer: initial results from the National Oncologic PET Registry. J Clin Oncol 2008;26:2155–61.CrossRefPubMed
43.
go back to reference Bruna C, Journo A, Netter F, Kaminsky MC, Dolivet G, Olivier P, et al. On the interest of PET with 18F-FDG in the management of cancer of unknown primary (CUP). Med Nucl 2007;31:242–9. Bruna C, Journo A, Netter F, Kaminsky MC, Dolivet G, Olivier P, et al. On the interest of PET with 18F-FDG in the management of cancer of unknown primary (CUP). Med Nucl 2007;31:242–9.
44.
go back to reference Wartski M, Le Stanc E, Gontier E, Vilain D, Banal A, Tainturier C, et al. In search of an unknown primary tumour presenting with cervical metastases: performance of hybrid FDG-PET-CT. Nucl Med Commun 2007;28:365–71.CrossRefPubMed Wartski M, Le Stanc E, Gontier E, Vilain D, Banal A, Tainturier C, et al. In search of an unknown primary tumour presenting with cervical metastases: performance of hybrid FDG-PET-CT. Nucl Med Commun 2007;28:365–71.CrossRefPubMed
45.
go back to reference Fakhry N, Barberet M, Lussato D, Cammilleri S, Mundler O, Giovanni A, et al. Role of [18F]-FDG PET-CT in the management of the head and neck cancers. Bull Cancer 2006;93:1017–25.PubMed Fakhry N, Barberet M, Lussato D, Cammilleri S, Mundler O, Giovanni A, et al. Role of [18F]-FDG PET-CT in the management of the head and neck cancers. Bull Cancer 2006;93:1017–25.PubMed
46.
go back to reference Pelosi E, Pennone M, Deandreis D, Douroukas A, Mancini M, Bisi G. Role of whole body positron emission tomography/computed tomography scan with 18F-fluorodeoxyglucose in patients with biopsy proven tumor metastases from unknown primary site. Q J Nucl Med Mol Imaging 2006;50:15–22.PubMed Pelosi E, Pennone M, Deandreis D, Douroukas A, Mancini M, Bisi G. Role of whole body positron emission tomography/computed tomography scan with 18F-fluorodeoxyglucose in patients with biopsy proven tumor metastases from unknown primary site. Q J Nucl Med Mol Imaging 2006;50:15–22.PubMed
47.
go back to reference Surti S, Kuhn A, Werner ME, Perkins AE, Kolthammer J, Karp JS. Performance of Philips Gemini TF PET/CT scanner with special consideration for its time-of-flight imaging capabilities. J Nucl Med 2007;48:471–80.PubMed Surti S, Kuhn A, Werner ME, Perkins AE, Kolthammer J, Karp JS. Performance of Philips Gemini TF PET/CT scanner with special consideration for its time-of-flight imaging capabilities. J Nucl Med 2007;48:471–80.PubMed
48.
go back to reference Kumar R, Dhanpathi H, Basu S, Rubello D, Fanti S, Alavi A. Oncologic PET tracers beyond [(18)F]FDG and the novel quantitative approaches in PET imaging. Q J Nucl Med Mol Imaging 2008;52:50–65.PubMed Kumar R, Dhanpathi H, Basu S, Rubello D, Fanti S, Alavi A. Oncologic PET tracers beyond [(18)F]FDG and the novel quantitative approaches in PET imaging. Q J Nucl Med Mol Imaging 2008;52:50–65.PubMed
49.
go back to reference Basu S, Kung J, Houseni M, Zhuang H, Tidmarsh GF, Alavi A. Temporal profile of fluorodeoxyglucose uptake in malignant lesions and normal organs over extended time periods in patients with lung carcinoma: implications for its utilization in assessing malignant lesions. Q J Nucl Med Mol Imaging 2009;53:9–19.PubMed Basu S, Kung J, Houseni M, Zhuang H, Tidmarsh GF, Alavi A. Temporal profile of fluorodeoxyglucose uptake in malignant lesions and normal organs over extended time periods in patients with lung carcinoma: implications for its utilization in assessing malignant lesions. Q J Nucl Med Mol Imaging 2009;53:9–19.PubMed
50.
go back to reference Sanz-Viedma S, Torigian DA, Parsons M, Basu S, Alavi A. Potential clinical utility of dual time point FDG-PET for distinguishing benign from malignant lesions: implications for oncological imaging. Rev Esp Med Nucl 2009;28:159–66.CrossRefPubMed Sanz-Viedma S, Torigian DA, Parsons M, Basu S, Alavi A. Potential clinical utility of dual time point FDG-PET for distinguishing benign from malignant lesions: implications for oncological imaging. Rev Esp Med Nucl 2009;28:159–66.CrossRefPubMed
51.
go back to reference Anzai Y, Minoshima S, Wolf GT, Wahl RL. Head and neck cancer: detection of recurrence with three-dimensional principal components analysis at dynamic FDG PET. Radiology 1999;212:285–90.PubMed Anzai Y, Minoshima S, Wolf GT, Wahl RL. Head and neck cancer: detection of recurrence with three-dimensional principal components analysis at dynamic FDG PET. Radiology 1999;212:285–90.PubMed
52.
go back to reference Pavlopoulos S, Thireou T, Kontaxakis G, Santos A. Analysis and interpretation of dynamic FDG PET oncological studies using data reduction techniques. Biomed Eng Online 2007;6:36.CrossRefPubMed Pavlopoulos S, Thireou T, Kontaxakis G, Santos A. Analysis and interpretation of dynamic FDG PET oncological studies using data reduction techniques. Biomed Eng Online 2007;6:36.CrossRefPubMed
53.
go back to reference Thireou T, Pavlopoulos S, Kontaxakis G, Santos A. Blind source separation for the computational analysis of dynamic oncological PET studies. Oncol Rep 2006;15:1007–12.PubMed Thireou T, Pavlopoulos S, Kontaxakis G, Santos A. Blind source separation for the computational analysis of dynamic oncological PET studies. Oncol Rep 2006;15:1007–12.PubMed
54.
go back to reference von Schulthess GK, Schlemmer HP. A look ahead: PET/MR versus PET/CT. Eur J Nucl Med Mol Imaging 2009;36(Suppl 1):S3–9.CrossRef von Schulthess GK, Schlemmer HP. A look ahead: PET/MR versus PET/CT. Eur J Nucl Med Mol Imaging 2009;36(Suppl 1):S3–9.CrossRef
55.
go back to reference Antoch G, Vogt FM, Freudenberg LS, Nazaradeh F, Goehde SC, Barkhausen J, et al. Whole-body dual-modality PET/CT and whole-body MRI for tumor staging in oncology. JAMA 2003;290:3199–206.CrossRefPubMed Antoch G, Vogt FM, Freudenberg LS, Nazaradeh F, Goehde SC, Barkhausen J, et al. Whole-body dual-modality PET/CT and whole-body MRI for tumor staging in oncology. JAMA 2003;290:3199–206.CrossRefPubMed
56.
go back to reference Kwee TC, Takahara T, Ochiai R, Katahira K, Van Cauteren M, Imai Y, et al. Whole-body diffusion-weighted magnetic resonance imaging. Eur J Radiol 2009;70:409–17.CrossRefPubMed Kwee TC, Takahara T, Ochiai R, Katahira K, Van Cauteren M, Imai Y, et al. Whole-body diffusion-weighted magnetic resonance imaging. Eur J Radiol 2009;70:409–17.CrossRefPubMed
57.
go back to reference Kwee TC, Takahara T, Ochiai R, Nievelstein RA, Luijten PR. Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS): features and potential applications in oncology. Eur Radiol 2008;18:1937–52.CrossRefPubMed Kwee TC, Takahara T, Ochiai R, Nievelstein RA, Luijten PR. Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS): features and potential applications in oncology. Eur Radiol 2008;18:1937–52.CrossRefPubMed
58.
go back to reference Gu TF, Xiao XL, Sun F, Yin JH, Zhao H. Diagnostic value of whole body diffusion weighted imaging for screening primary tumors of patients with metastases. Chin Med Sci J 2008;23:145–50.CrossRefPubMed Gu TF, Xiao XL, Sun F, Yin JH, Zhao H. Diagnostic value of whole body diffusion weighted imaging for screening primary tumors of patients with metastases. Chin Med Sci J 2008;23:145–50.CrossRefPubMed
59.
go back to reference Mori T, Nomori H, Ikeda K, Kawanaka K, Shiraishi S, Katahira K, et al. Diffusion-weighted magnetic resonance imaging for diagnosing malignant pulmonary nodules/masses: comparison with positron emission tomography. J Thorac Oncol 2008;3:358–64.CrossRefPubMed Mori T, Nomori H, Ikeda K, Kawanaka K, Shiraishi S, Katahira K, et al. Diffusion-weighted magnetic resonance imaging for diagnosing malignant pulmonary nodules/masses: comparison with positron emission tomography. J Thorac Oncol 2008;3:358–64.CrossRefPubMed
60.
go back to reference Varadhachary GR, Talantov D, Raber MN, Meng C, Hess KR, Jatkoe T, et al. Molecular profiling of carcinoma of unknown primary and correlation with clinical evaluation. J Clin Oncol 2008;26:4442–8.CrossRefPubMed Varadhachary GR, Talantov D, Raber MN, Meng C, Hess KR, Jatkoe T, et al. Molecular profiling of carcinoma of unknown primary and correlation with clinical evaluation. J Clin Oncol 2008;26:4442–8.CrossRefPubMed
61.
go back to reference Horlings HM, van Laar RK, Kerst JM, Helgason HH, Wesseling J, van der Hoeven JJ, et al. Gene expression profiling to identify the histogenetic origin of metastatic adenocarcinomas of unknown primary. J Clin Oncol 2008;26:4435–41.CrossRefPubMed Horlings HM, van Laar RK, Kerst JM, Helgason HH, Wesseling J, van der Hoeven JJ, et al. Gene expression profiling to identify the histogenetic origin of metastatic adenocarcinomas of unknown primary. J Clin Oncol 2008;26:4435–41.CrossRefPubMed
Metadata
Title
FDG PET/CT in carcinoma of unknown primary
Authors
Thomas C. Kwee
Sandip Basu
Gang Cheng
Abass Alavi
Publication date
01-03-2010
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 3/2010
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-009-1295-6

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