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Annals of Nuclear Medicine
Published in: Annals of Nuclear Medicine 2/2019

01-02-2019 | Original Article

Usefulness of both PET/CT with F18-FDG and whole-body diffusion-weighted imaging in cancer screening: a preliminary report

Authors: Hiroto Sasamori, Kimiichi Uno, Jin Wu

Published in: Annals of Nuclear Medicine | Issue 2/2019

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Abstract

Objective

Positron emission tomography/computed tomography (PET/CT) with fluorodeoxyglucose (F18-FDG) is useful for the detection of malignant lesions, including metastatic lesions, and this technique is widely used in cancer screening. However, this approach may occasionally yield false-positive and false-negative findings. At our PET center, to increase the accuracy of PET/CT, we use PET/CT and whole-body diffusion-weighted imaging (WB-DWI) together. This study aimed to assess the usefulness of this combination.

Methods

We examined 29 subjects with confirmed diagnosis. All of them had undergone PET/CT and WB-DWI on the same day. Twenty-seven of them also underwent ultrasonography, blood testing, and upper gastrointestinal series on the same day and two fecal occult blood tests on another day. WB-DWI was performed on a 1.5-T MRI unit with a b value of 0 and 800 or 1000 s/mm2. For all 29 cases, PET/CT and WB-DWI were classified to be positive or negative, and the diagnostic ability was calculated for each modality.

Results

Among the 29 subjects, 17 had malignant tumors and 12 had benign tumors or no abnormalities. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PET/CT were 65%, 25%, 55%, 33%, and 48%, respectively; while the corresponding values for WB-DWI were 59%, 100%, 100%, 63%, and 76%, respectively. By considering the result to be negative when PET/CT findings were positive but WB-DWI findings were negative, specificity increased from 25 to 100%, and accuracy increased from 48 to 76%. On the other hand, by considering the result to be positive when the findings of either PET/CT or WB-DWI were positive, sensitivity increased from 65 to 76%, and accuracy increased from 48 to 55%.

Conclusions

Our results suggest that using both PET/CT and WB-DWI together can increase accuracy in cancer screening. However, this approach was not able to detect malignant lesions in some cases, indicating that there were limitations with imaging certain organs. Therefore, it is important to further understand the features of PET/CT and WB-DWI and use them appropriately for each organ. Additionally, given that the study sample was relatively small, further research is needed to validate these findings.
Literature
1.
Minamimoto R, Senda M, Jinnouchi S, Terauchi T, Yoshida T, Murano T, et al. The current status of an FDG-PET cancer screening program in Japan, based on a 4-year (2006–2009) nationwide survey. Ann Nucl Med. 2013;27:46–57.CrossRefPubMed
2.
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(12):1842–8.CrossRefPubMed
3.
Nishizawa S, Okada Y. PET cancer screening with multiple imaging modalities: current status and prospects. Jpn J Clin Radiol. 2017;62:645–53.
4.
Takahara T, Imai Y, Yamashita T, Yasuda S, Nasu S, Cauteren M. Diffusion weighted whole body imaging with background body signal suppression (DWIBS): technical improvement using free breathing, STIR and high resolution 3D display. Radiat Med. 2004;22(4):275–82.PubMed
5.
Li B, Li Q, Nie W, Liu S. Diagnostic value of whole-body diffusion-weighted magnetic resonance imaging for detection of primary and metastatic malignancies: a meta-analysis. Eur J Radiol. 2014;83(2):338–44.CrossRefPubMed
6.
Komori T, Narabayashi I, Matsumura K, Matsuki M, Akagi H, Ogura Y, et al. 2-[Fluorine-18]-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography versus whole-body diffusion-weighted MRI for detection of malignant lesions: initial experience. Ann Nucl Med. 2007;21(4):209–15.CrossRefPubMed
7.
Naganawa S, Yoshikawa T, Yasaka K, Maeda E, Hayashi N, Abe O. Role of delayed-time-point imaging during abdominal and pelvic cancer screening using FDG-PET/CT in the general population. Medicine. 2017;96:46.CrossRef
8.
Chen SQ, Huang M, Shen YY, Liu CL, Xu CX. Abbreviated MRI protocols for detecting breast cancer in women with dense breasts. Korean J Radiol. 2017;18(3):470–5.CrossRefPubMedPubMedCentral
9.
Volpi S, Ali JM, Tasker A, Peryt A, Aresu G, Coonar AS. The role of positron emission tomography in the diagnosis, staging and response assessment of non-small cell lung cancer. Ann Transl Med. 2018;6(5):95.CrossRefPubMedPubMedCentral
10.
Usuda K, Sagawa M, Motono N, Ueno M, Tanaka M, Machida Y, et al. Diagnostic performance of diffusion weighted imaging of malignant and benign pulmonary nodules and masses: comparison with positron emission tomography. Asian Pac J Cancer Prev. 2014;15(11):4629–35.CrossRefPubMed
11.
Usuda K, Sagawa M, Maeda S, Motono N, Tanaka M, Machida Y, et al. Diagnostic performance of whole-body diffusion-weighted imaging compared to PET-CT plus brain MRI in staging clinically resectable lung cancer. Asian Pac J Cancer Prev. 2016;17(6):2775–80.PubMed
12.
Groheux D, Espié M, Giacchetti S, Hindié E. Performance of FDG PET/CT in the clinical management of breast cancer. Radiology. 2013;266(2):388–405.CrossRefPubMed
13.
14.
Stadlbauer A, Bernt R, Gruber S, Bogner W, Pinker K, van der Riet W, et al. Diffusion-weighted MR imaging with background body signal suppression (DWIBS) for the diagnosis of malignant and benign breast lesions. Eur Radiol. 2009;19(10):2349–56.CrossRefPubMed
15.
16.
Goyal A, Sharma R, Bhalla AS, Gamanagatti S, Seth A. Comparison of MDCT, MRI and MRI with diffusion-weighted imaging in evaluation of focal renal lesions: the defender, challenger, and winner! Indian J Radiol Imaging. 2018;28(1):27–36.CrossRefPubMedPubMedCentral
17.
Chen YK, Su CT, Chi KH, Cheng RH, Wang SC, Hsu CH. Utility of 18F-FDG PET/CT uptake patterns in Waldeyer’s ring for differentiating benign from malignant lesions in lateral pharyngeal recess of nasopharynx. J Nucl Med. 2007;48:8–14.PubMed
18.
Bhatia KS, King AD, Yeung DK, Mo F, Vlantis AC, Yu KH, et al. Can diffusion-weighted imaging distinguish between normal and squamous cell carcinoma of the palatine tonsil? Br J Radiol. 2010;83:753–8.CrossRefPubMedPubMedCentral
19.
Usuda K, Maeda S, Motono N, Ueno M, Tanaka M, Machida Y, et al. Diagnostic performance of diffusion-weighted imaging for multiple hilar and mediastinal lymph nodes with FDG accumulation. Asian Pac J Cancer Prev. 2015;16(15):6401–6.CrossRefPubMed
20.
21.
William M, Anthony C. Thyroid incidentalomas on 18F-FDG PET/CT: clinical significance and controversies. Mol Imaging Radionucl Ther. 2017;26:93–100.CrossRef
22.
Minamimoto R, Senda M, Terauchi T, Jinnouchi S, Inoue T, Iinuma T, et al. Analysis of various malignant neoplasms detected by FDG-PET cancer screening program: based on a Japanese Nationwide Survey. Ann Nucl Med. 2011;25(1):45–54.CrossRefPubMed
23.
24.
Levin B, Lieberman DA, McFarland B, Andrews KS, Brooks D, Bond J, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA Cancer J Clin. 2008;58:130–60.CrossRefPubMed
25.
Leufkens AM, Kwee TC, van den Bosch MA, Mali WP, Takahara T, Siersema PD. Diffusion-weighted MRI for the detection of colorectal polyps: feasibility study. Magn Reson Imaging. 2013;31(1):28–35.CrossRefPubMed
26.
Eugénie R, Laurence L, Guillaume B, Mael P, Astrid L, Etienne G, et al. Incidental colorectal focal 18F-FDG uptake: a novel indication for colonoscopy. Endosc Int Open. 2017;05:E92430.
27.
Avcu S, Koseoglu MN, Ceylan K, Bulut MD, Unal O. The value of diffusion-weighted MRI in the diagnosis of malignant and benign urinary bladder lesions. Br J Radiol. 2011;84:875–82.CrossRefPubMedPubMedCentral
28.
Bednarova S, Lindenberg ML, Vinsensia M, Zuiani C, Choyke PL, Turkbey B. Positron emission tomography (PET) in primary prostate cancer staging and risk assessment. Transl Androl Urol. 2017;6(3):413–23.CrossRefPubMedPubMedCentral
29.
30.
Weinreb JC, Barentsz JO, Choyke PL, Cornud F, Haider MA, Macura KJ, et al. PI-RADS prostate imaging—reporting and data system: 2015, version 2. Eur Urol. 2016;69(1):16–40.CrossRefPubMed
31.
Tarnoki DL, Tarnoki AD, Richter A, Karlinger K, Berczi V, Pickuth D. Clinical value of whole-body magnetic resonance imaging in health screening of general adult population. Radiol Oncol. 2015;49(1):10–6.CrossRefPubMedPubMedCentral
Metadata
Title
Usefulness of both PET/CT with F18-FDG and whole-body diffusion-weighted imaging in cancer screening: a preliminary report
Authors
Hiroto Sasamori
Kimiichi Uno
Jin Wu
Publication date
01-02-2019
Publisher
Springer Singapore
Published in
Annals of Nuclear Medicine / Issue 2/2019
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-018-1307-3

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