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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 5/2006

01-05-2006 | Original article

The presentation of malignant tumours and pre-malignant lesions incidentally found on PET-CT

Authors: Einat Even-Sapir, Hedva Lerman, Mordechai Gutman, Gennady Lievshitz, Limor Zuriel, Aaron Polliack, Moshe Inbar, Ur Metser

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 5/2006

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Abstract

Purpose

The purpose of the study was to determine the general and organ-specific presentation of incidental primary tumours on PET-CT.

Methods

PET-CT reports of 2,360 consecutive patients were reviewed and revealed 156 lesions suspicious for a new unexpected malignancy, in 151 patients. One hundred and twenty of these lesions, in 115 patients, were further assessed, by biopsy (n=84 patients) or by clinical and imaging follow-up (n=31 patients) for a mean of 17±4 months (range 12–25 months).

Results

Forty-four unexpected malignancies were found in 41 of the study patients (1.7%). Twenty-seven of the 44 incidental tumours were identified on the basis of their location, which was uncommon for metastasis of the known malignancy. Eight were detected as a result of either the difference in FDG avidity of the known malignancy and the incidental lesion or the presence of an incidental non-FDG-avid mass on the CT part of the study. Four tumours were synchronous carcinomas in patients with known colorectal malignancy, three were identified by virtue of the discordant response to treatment compared with the known primary tumour and two were detected as new sites of disease after a prolonged disease-free period. There was organ variability in the positive predictive values (PPV) of PET-CT findings for incidental primary malignancy or pre-malignant lesions: 62% for colonic lesions, 54% for lung lesions and 24% for thyroid lesions.

Conclusion

Incidental primary tumours may be identified on PET-CT based on their location, FDG avidity, response to therapy and time of appearance. The PET and CT parts of the study appear to complement each other and assist in identification of these incidental tumours.
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Metadata
Title
The presentation of malignant tumours and pre-malignant lesions incidentally found on PET-CT
Authors
Einat Even-Sapir
Hedva Lerman
Mordechai Gutman
Gennady Lievshitz
Limor Zuriel
Aaron Polliack
Moshe Inbar
Ur Metser
Publication date
01-05-2006
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 5/2006
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-005-0056-4

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