Skip to main content
Top
Published in: Annals of Nuclear Medicine 1/2011

01-01-2011 | Original Article

Analysis of various malignant neoplasms detected by FDG-PET cancer screening program: based on a Japanese Nationwide Survey

Authors: Ryogo Minamimoto, Michio Senda, Takashi Terauchi, Seishi Jinnouchi, Tomio Inoue, Takeshi Iinuma, Takeshi Inoue, Kengo Ito, Hiroshi Iwata, Kimiichi Uno, Shinya Oku, Kazuhiro Oguchi, Eriko Tsukamoto, Rumi Nakashima, Sadahiko Nishizawa, Hiroshi Fukuda, Takeshi Murano, Tsuyoshi Yoshida

Published in: Annals of Nuclear Medicine | Issue 1/2011

Login to get access

Abstract

Objective

The most distinctive feature of FDG-PET cancer screening program is the ability to find various kinds of malignant neoplasms in a single test. The aim of this survey is to clarify the range and frequency of various malignant neoplasms detected by FDG-PET cancer screening performed in Japan.

Methods

“FDG-PET cancer screening” was defined as FDG-PET or positron emission tomography and computed tomography (PET/CT) scan with or without other tests performed for cancer screening of healthy subjects. This survey was based on a questionnaire regarding FDG-PET cancer screening. We analyzed the situation of 9 less frequently found malignant neoplasms including malignant lymphoma, malignancy of head and neck, esophagus, hepatobiliary and gallbladder, pancreas, kidney, cervical and uterine, ovary, and bladder.

Results

The detailed information of subjects with the suspected 9 kinds of malignant neoplasms mentioned above in the FDG-PET cancer screening program was studied in a total of 1,219 cases from 212 facilities. A statistical significance between PET/CT and PET was found in relative sensitivity and PPV for renal cell cancer. Malignant lymphoma was frequently of indolent type, suspected head and neck cancers had many false-positive results, and pancreatic cancer detected in this program was often in the advanced stage even in asymptomatic subjects. The recommendation of combined screening modality to PET or PET/CT was as follows: gastric endoscopy for assessing early esophageal cancer; abdominal ultrasound for screening hepatobiliary and gallbladder cancer; pelvic magnetic resonance imaging for assessing gynecological and pelvic cancers; and the CA125 blood test for screening ovarian cancer. Delayed image was helpful depending on the type of suspected malignant neoplasm.

Conclusion

We analyzed various types of malignant neoplasms detected by the FDG-PET cancer screening program and presented recommended combination of examinations to cover FDG-PET and PET/CT.
Literature
1.
go back to reference Yeung HW, Schöder H, Smith A, Gonen M, Larson SM. Clinical value of combined positron emission tomography/computed tomography imaging in the interpretation of 2-deoxy-2-[F-18]fluoro-d-glucose-positron emission tomography studies in cancer patients. Mol Imaging Biol. 2005;7:229–35.CrossRefPubMed Yeung HW, Schöder H, Smith A, Gonen M, Larson SM. Clinical value of combined positron emission tomography/computed tomography imaging in the interpretation of 2-deoxy-2-[F-18]fluoro-d-glucose-positron emission tomography studies in cancer patients. Mol Imaging Biol. 2005;7:229–35.CrossRefPubMed
2.
go back to reference Ide M. Cancer screening with FDG-PET. Q J Nucl Med Mol Imaging. 2006;50:23–7.PubMed Ide M. Cancer screening with FDG-PET. Q J Nucl Med Mol Imaging. 2006;50:23–7.PubMed
3.
go back to reference Minamimoto R, Senda M, Uno K, Jinnouchi S, Iinuma T, Ito K, et al. Performance profile of FDG-PET and PET/CT for cancer screening on the basis of a Japanese Nationwide Survey. Ann Nucl Med. 2007;21:481–98.CrossRefPubMed Minamimoto R, Senda M, Uno K, Jinnouchi S, Iinuma T, Ito K, et al. Performance profile of FDG-PET and PET/CT for cancer screening on the basis of a Japanese Nationwide Survey. Ann Nucl Med. 2007;21:481–98.CrossRefPubMed
4.
go back to reference The guideline of FDG-PET cancer screening. Kaku Igaku. 2004; 41:1–21. The guideline of FDG-PET cancer screening. Kaku Igaku. 2004; 41:1–21.
5.
go back to reference The guideline of FDG-PET cancer screening 2007. Kaku Igaku. 2007; 44:1–28. The guideline of FDG-PET cancer screening 2007. Kaku Igaku. 2007; 44:1–28.
6.
go back to reference Kojima S, Zhou B, Teramukai S, Hara A, Kosaka N, Matsuo Y, et al. Cancer screening of healthy volunteers using whole-body 18F-FDG-PET scans: the Nishidai clinic study. Eur J Cancer. 2007;43:1842–8.CrossRefPubMed Kojima S, Zhou B, Teramukai S, Hara A, Kosaka N, Matsuo Y, et al. Cancer screening of healthy volunteers using whole-body 18F-FDG-PET scans: the Nishidai clinic study. Eur J Cancer. 2007;43:1842–8.CrossRefPubMed
7.
go back to reference Nishizawa S, Kojima S, Teramukai S, Inubushi M, Kodama H, Maeda Y, et al. Prospective evaluation of whole-body cancer screening with multiple modalities including [18F]fluorodeoxyglucose positron emission tomography in a healthy population: a preliminary report. J Clin Oncol. 2009;27:1767–73.CrossRefPubMed Nishizawa S, Kojima S, Teramukai S, Inubushi M, Kodama H, Maeda Y, et al. Prospective evaluation of whole-body cancer screening with multiple modalities including [18F]fluorodeoxyglucose positron emission tomography in a healthy population: a preliminary report. J Clin Oncol. 2009;27:1767–73.CrossRefPubMed
8.
go back to reference The Foundation of Cancer Research (FPCR). Cancer Statistics in Japan, 2009. The Foundation of Cancer Research (FPCR). Cancer Statistics in Japan, 2009.
9.
go back to reference Schöder H, Gönen M. Screening for cancer with PET and PET/CT: potential and limitations. J Nucl Med. 2007;48(Suppl 1):4S–18S.PubMed Schöder H, Gönen M. Screening for cancer with PET and PET/CT: potential and limitations. J Nucl Med. 2007;48(Suppl 1):4S–18S.PubMed
10.
go back to reference Schöder H, Noy A, Gönen M, Weng L, Green D, Erdi YE, et al. Intensity of 18fluorodeoxyglucose uptake in positron emission tomography distinguishes between indolent and aggressive non-Hodgkin’s lymphoma. J Clin Oncol. 2005;23:4643–51.CrossRefPubMed Schöder H, Noy A, Gönen M, Weng L, Green D, Erdi YE, et al. Intensity of 18fluorodeoxyglucose uptake in positron emission tomography distinguishes between indolent and aggressive non-Hodgkin’s lymphoma. J Clin Oncol. 2005;23:4643–51.CrossRefPubMed
11.
go back to reference Fueger BJ, Yeom K, Czernin J, Sayre JW, Phelps ME, Allen-Auerbach MS. Comparison of CT, PET, and PET/CT for staging of patients with indolent non- Hodgkin’s lymphoma. Mol Imaging Biol. 2009;11:269–74.CrossRefPubMed Fueger BJ, Yeom K, Czernin J, Sayre JW, Phelps ME, Allen-Auerbach MS. Comparison of CT, PET, and PET/CT for staging of patients with indolent non- Hodgkin’s lymphoma. Mol Imaging Biol. 2009;11:269–74.CrossRefPubMed
12.
go back to reference Wahl RL. Principles and practice of PET and PET/CT. 2nd ed. Lippincott Williams & Wilkins; 2009. p. 221–39. Wahl RL. Principles and practice of PET and PET/CT. 2nd ed. Lippincott Williams & Wilkins; 2009. p. 221–39.
13.
go back to reference Flamen P, Lerut A, Van Cutsem E, De Wever W, Peeters M, Stroobants S, et al. Utility of positron emission tomography for the staging of patients with potentially operable esophageal carcinoma. J Clin Oncol. 2000;18:3202–10.PubMed Flamen P, Lerut A, Van Cutsem E, De Wever W, Peeters M, Stroobants S, et al. Utility of positron emission tomography for the staging of patients with potentially operable esophageal carcinoma. J Clin Oncol. 2000;18:3202–10.PubMed
14.
go back to reference Ott K, Weber WA, Fink U, Helmberger H, Becker K, Stein HJ, et al. Fluorodeoxyglucose-positron emission tomography in adenocarcinomas of the distal esophagus and cardia. World J Surg. 2003;27:1035–9.CrossRefPubMed Ott K, Weber WA, Fink U, Helmberger H, Becker K, Stein HJ, et al. Fluorodeoxyglucose-positron emission tomography in adenocarcinomas of the distal esophagus and cardia. World J Surg. 2003;27:1035–9.CrossRefPubMed
15.
go back to reference Weber G, Morris HP. Comparative biochemistry of hepatomas. III. Carbohydrate enzymes in liver tumors of different growth rates. Cancer Res. 1963;23:987–94.PubMed Weber G, Morris HP. Comparative biochemistry of hepatomas. III. Carbohydrate enzymes in liver tumors of different growth rates. Cancer Res. 1963;23:987–94.PubMed
16.
go back to reference De Santis M, Romagnoli R, Cristani A, Cioni G, Casolo A, Vici FF, et al. MRI of small hepatocellular carcinoma: comparison with US, CT, DSA, and Lipiodol-CT. J Comput Assist Tomogr. 1992;16:189–97.CrossRefPubMed De Santis M, Romagnoli R, Cristani A, Cioni G, Casolo A, Vici FF, et al. MRI of small hepatocellular carcinoma: comparison with US, CT, DSA, and Lipiodol-CT. J Comput Assist Tomogr. 1992;16:189–97.CrossRefPubMed
17.
go back to reference Yoon SK. Recent advances in tumor markers of human hepatocellular carcinoma. Intervirology. 2008;51(Suppl 1):34–41.CrossRefPubMed Yoon SK. Recent advances in tumor markers of human hepatocellular carcinoma. Intervirology. 2008;51(Suppl 1):34–41.CrossRefPubMed
18.
go back to reference Stefaniuk P, Cianciara J, Wiercinska-Drapalo A. Present and future possibilities for early diagnosis of hepatocellular carcinoma. World J Gastroenterol. 2010;16:418–24.CrossRefPubMed Stefaniuk P, Cianciara J, Wiercinska-Drapalo A. Present and future possibilities for early diagnosis of hepatocellular carcinoma. World J Gastroenterol. 2010;16:418–24.CrossRefPubMed
19.
go back to reference Nomura F, Ohnishi K, Tanabe Y. Clinical features and prognosis of hepatocellular carcinoma with reference to serum alpha-fetoprotein levels. Analysis of 606 patients. Cancer. 1989;64:1700–7.CrossRefPubMed Nomura F, Ohnishi K, Tanabe Y. Clinical features and prognosis of hepatocellular carcinoma with reference to serum alpha-fetoprotein levels. Analysis of 606 patients. Cancer. 1989;64:1700–7.CrossRefPubMed
20.
go back to reference Trevisani F, D’Intino PE, Morselli-Labate AM, Mazzella G, Accogli E, Caraceni PJ, et al. Serum alpha-fetoprotein for diagnosis of hepatocellular carcinoma in patients with chronic liver disease: influence of HBsAg and anti-HCV status. J Hepatol. 2001;34:570–5.CrossRefPubMed Trevisani F, D’Intino PE, Morselli-Labate AM, Mazzella G, Accogli E, Caraceni PJ, et al. Serum alpha-fetoprotein for diagnosis of hepatocellular carcinoma in patients with chronic liver disease: influence of HBsAg and anti-HCV status. J Hepatol. 2001;34:570–5.CrossRefPubMed
21.
go back to reference Beger HG, Rau B, Gansauge F, Poch B, Link KH. Treatment of pancreatic cancer: challenge of the facts. World J Surg. 2003;27:1075–84.CrossRefPubMed Beger HG, Rau B, Gansauge F, Poch B, Link KH. Treatment of pancreatic cancer: challenge of the facts. World J Surg. 2003;27:1075–84.CrossRefPubMed
22.
go back to reference Rose DM, Delbeke D, Beauchamp RD, Chapman WC, Sandler MP, Sharp KW, et al. 18Fluorodeoxyglucose-positron emission tomography in the management of patients with suspected pancreatic cancer. Ann Surg. 1999;229:729–37 (discussion).CrossRefPubMed Rose DM, Delbeke D, Beauchamp RD, Chapman WC, Sandler MP, Sharp KW, et al. 18Fluorodeoxyglucose-positron emission tomography in the management of patients with suspected pancreatic cancer. Ann Surg. 1999;229:729–37 (discussion).CrossRefPubMed
23.
go back to reference Delbeke D, Rose DM, Chapman WC, Pinson CW, Wright JK, Beauchamp RD, et al. Optimal interpretation of FDG PET in the diagnosis, staging and management of pancreatic carcinoma. J Nucl Med. 1999;40:1784–91.PubMed Delbeke D, Rose DM, Chapman WC, Pinson CW, Wright JK, Beauchamp RD, et al. Optimal interpretation of FDG PET in the diagnosis, staging and management of pancreatic carcinoma. J Nucl Med. 1999;40:1784–91.PubMed
24.
go back to reference Wahl RL. Principles and practice of PET and PET/CT. 2nd ed. Lippincott Williams & Wilkins; 2009. p. 331–47. Wahl RL. Principles and practice of PET and PET/CT. 2nd ed. Lippincott Williams & Wilkins; 2009. p. 331–47.
25.
go back to reference Steinberg WM, Gelfand R, Anderson KK, Glenn J, Kurtzman SH, Sindelar WF, et al. Comparison of the sensitivity and specificity of the CA19–9 and carcinoembryonic antigen assays in detecting cancer of the pancreas. Gastroenterology. 1986;90:343–9.PubMed Steinberg WM, Gelfand R, Anderson KK, Glenn J, Kurtzman SH, Sindelar WF, et al. Comparison of the sensitivity and specificity of the CA19–9 and carcinoembryonic antigen assays in detecting cancer of the pancreas. Gastroenterology. 1986;90:343–9.PubMed
26.
go back to reference Homma T, Tsuchiya R. The study of the mass screening of persons without symptoms and of the screening of outpatients with gastrointestinal complaints or icterus for pancreatic cancer in Japan, using CA19-9 and elastase-1 or ultrasonography. Int J Pancreatol. 1991;9:119–24.PubMed Homma T, Tsuchiya R. The study of the mass screening of persons without symptoms and of the screening of outpatients with gastrointestinal complaints or icterus for pancreatic cancer in Japan, using CA19-9 and elastase-1 or ultrasonography. Int J Pancreatol. 1991;9:119–24.PubMed
27.
go back to reference Montravers F, Grahek D, Kerrou K, Younsi N, Doublet JD, Gattegno B, et al. Evaluation of FDG uptake by renal malignancies (primary tumor or metastases) using a coincidence detection gamma camera. J Nucl Med. 2000;41:78–84.PubMed Montravers F, Grahek D, Kerrou K, Younsi N, Doublet JD, Gattegno B, et al. Evaluation of FDG uptake by renal malignancies (primary tumor or metastases) using a coincidence detection gamma camera. J Nucl Med. 2000;41:78–84.PubMed
28.
go back to reference Kopka L, Fischer U, Zoeller G, Schmidt C, Ringert RH, Grabbe E. Dual-phase helical CT of the kidney: value of the corticomedullary and nephrographic phase for evaluation of renal lesions and preoperative staging of renal cell carcinoma. AJR Am J Roentgenol. 1997;169:1573–8.PubMed Kopka L, Fischer U, Zoeller G, Schmidt C, Ringert RH, Grabbe E. Dual-phase helical CT of the kidney: value of the corticomedullary and nephrographic phase for evaluation of renal lesions and preoperative staging of renal cell carcinoma. AJR Am J Roentgenol. 1997;169:1573–8.PubMed
29.
go back to reference Wahl RL. Principles and practice of PET and PET/CT. 2nd ed. Lippincott Williams & Wilkins; 2009. p. 348–54. Wahl RL. Principles and practice of PET and PET/CT. 2nd ed. Lippincott Williams & Wilkins; 2009. p. 348–54.
30.
go back to reference Chao A, Chang TC, Ng KK, Hsueh S, Huang HJ, Chou HH, et al. 18F-FDG PET in the management of endometrial cancer. Eur J Nucl Med Mol Imaging. 2006;33:36–44.CrossRefPubMed Chao A, Chang TC, Ng KK, Hsueh S, Huang HJ, Chou HH, et al. 18F-FDG PET in the management of endometrial cancer. Eur J Nucl Med Mol Imaging. 2006;33:36–44.CrossRefPubMed
31.
go back to reference Nishizawa S, Inubushi M, Kido A, Miyagawa M, Inoue T, Shinohara K, et al. Incidence and characteristics of uterine leiomyomas with FDG uptake. Ann Nucl Med. 2008;22:803–10.CrossRefPubMed Nishizawa S, Inubushi M, Kido A, Miyagawa M, Inoue T, Shinohara K, et al. Incidence and characteristics of uterine leiomyomas with FDG uptake. Ann Nucl Med. 2008;22:803–10.CrossRefPubMed
32.
go back to reference Kitajima K, Murakami K, Yamasaki E, Kaji Y, Sugimura K. Standardized uptake values of uterine leiomyoma with 18F-FDG PET/CT: variation with age, size, degeneration, and contrast enhancement on MRI. Ann Nucl Med. 2008;22:505–12.CrossRefPubMed Kitajima K, Murakami K, Yamasaki E, Kaji Y, Sugimura K. Standardized uptake values of uterine leiomyoma with 18F-FDG PET/CT: variation with age, size, degeneration, and contrast enhancement on MRI. Ann Nucl Med. 2008;22:505–12.CrossRefPubMed
33.
go back to reference Lerman H, Metser U, Grisaru D, Fishman A, Lievshitz G, Even-Sapir E. Normal and abnormal 18F-FDG endometrial and ovarian uptake in pre- and postmenopausal patients: assessment by PET/CT. J Nucl Med. 2004;45:266–71.PubMed Lerman H, Metser U, Grisaru D, Fishman A, Lievshitz G, Even-Sapir E. Normal and abnormal 18F-FDG endometrial and ovarian uptake in pre- and postmenopausal patients: assessment by PET/CT. J Nucl Med. 2004;45:266–71.PubMed
34.
go back to reference Einhorn N, Sjövall K, Knapp RC, Hall P, Scully RE, Bast RC Jr, et al. Prospective evaluation of serum CA 125 levels for early detection of ovarian cancer. Obstet Gynecol. 1992;80:14–8.PubMed Einhorn N, Sjövall K, Knapp RC, Hall P, Scully RE, Bast RC Jr, et al. Prospective evaluation of serum CA 125 levels for early detection of ovarian cancer. Obstet Gynecol. 1992;80:14–8.PubMed
35.
go back to reference Risum S, Høgdall C, Loft A, Berthelsen AK, Høgdall E, Nedergaard L, et al. The diagnostic value of PET/CT for primary ovarian cancer–a prospective study. Gynecol Oncol. 2007;105:145–9.CrossRefPubMed Risum S, Høgdall C, Loft A, Berthelsen AK, Høgdall E, Nedergaard L, et al. The diagnostic value of PET/CT for primary ovarian cancer–a prospective study. Gynecol Oncol. 2007;105:145–9.CrossRefPubMed
36.
go back to reference Hiatt RA, Ordoñez JD. Dipstick urinalysis screening, asymptomatic microhematuria, and subsequent urological cancers in a population-based sample. Cancer Epidemiol Biomarkers Prev. 1994;3:439–43.PubMed Hiatt RA, Ordoñez JD. Dipstick urinalysis screening, asymptomatic microhematuria, and subsequent urological cancers in a population-based sample. Cancer Epidemiol Biomarkers Prev. 1994;3:439–43.PubMed
37.
go back to reference Kubota K, Itoh M, Ozaki K, Ono S, Tashiro M, Yamaguchi K, et al. Advantage of delayed whole-body FDG-PET imaging for tumour detection. Eur J Nucl Med. 2001;28:696–703.CrossRefPubMed Kubota K, Itoh M, Ozaki K, Ono S, Tashiro M, Yamaguchi K, et al. Advantage of delayed whole-body FDG-PET imaging for tumour detection. Eur J Nucl Med. 2001;28:696–703.CrossRefPubMed
Metadata
Title
Analysis of various malignant neoplasms detected by FDG-PET cancer screening program: based on a Japanese Nationwide Survey
Authors
Ryogo Minamimoto
Michio Senda
Takashi Terauchi
Seishi Jinnouchi
Tomio Inoue
Takeshi Iinuma
Takeshi Inoue
Kengo Ito
Hiroshi Iwata
Kimiichi Uno
Shinya Oku
Kazuhiro Oguchi
Eriko Tsukamoto
Rumi Nakashima
Sadahiko Nishizawa
Hiroshi Fukuda
Takeshi Murano
Tsuyoshi Yoshida
Publication date
01-01-2011
Publisher
Springer Japan
Published in
Annals of Nuclear Medicine / Issue 1/2011
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-010-0428-0

Other articles of this Issue 1/2011

Annals of Nuclear Medicine 1/2011 Go to the issue