Detection of colorectal cancer and adenomas by FDG-PET cancer screening program: results based on a nationwide Japanese

  • PDF / 201,735 Bytes
  • 8 Pages / 595.276 x 790.866 pts Page_size
  • 59 Downloads / 148 Views

DOWNLOAD

REPORT


ORIGINAL ARTICLE

Detection of colorectal cancer and adenomas by FDG-PET cancer screening program: results based on a nationwide Japanese survey Ryogo Minamimoto • Michio Senda • Seishi Jinnouchi • Takashi Terauchi • Tsuyoshi Yoshida • Tomio Inoue

Received: 28 July 2013 / Accepted: 5 December 2013 Ó The Japanese Society of Nuclear Medicine 2013

Abstract Purpose The aim of this study was to analyze the detection rate for CRC and adenomas for asymptomatic subjects in Japan by FDG-PET cancer screening program carried out between 2006 and 2009. Methods The ‘‘FDG-PET cancer screening program’’ included both PET and positron emission tomography with computed tomography (PET/CT) with or without other screening tests. A total of 154,783 asymptomatic subjects underwent FDG-PET cancer screening program; we analyzed the 1,808 cases with findings from any detection method that indicated suspected CRC. Results Among the 1,808 cases, the number of cases verified as CRC and adenoma was 394 and 679, R. Minamimoto (&) Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan e-mail: [email protected] R. Minamimoto  T. Inoue Department of Radiology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan M. Senda Division of Molecular Imaging, Institute of Biomedical Research and Innovation, Kobe, Japan S. Jinnouchi Atsuchi Memorial Institute of Radiology, Atsuchi Memorial Clinic PET Center, Kagoshima, Japan T. Terauchi Division of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan T. Yoshida PET Imaging Center, Koga Hospital 21, Kurume, Japan

respectively. The sensitivity and positive predictive value (PPV) of FDG-PET were 86.0 and 31.7 % for CRC, and 63.6 and 63.8 % for CRC and adenoma. The sensitivity and PPV of fecal occult blood test (FOBT) for CRC were lower than those of FDG-PET, but higher for adenoma. Therefore, FDG-PET and FOBT were complementary for screening for CRC, and CRC and adenoma. The majority of CRC detected by the FDG-PET imaging was UICC stage 0 or I, however, detection of smaller or less invasive cancer was limited. Conclusion The FDG-PET screening program in Japan has detected CRC at an early stage and adenomas as premalignant lesions. A combination of FDG-PET and FOBT yields the best results if the intent is to detect either CRC or adenoma. However, it is absolutely clear that an FDG-PET cancer screening program cannot detect all colon lesions. Keywords FDG  PET  PET/CT  Cancer screening  Colon/rectal cancer (CRC)  Adenoma

Introduction Cancer screening is defined as the investigation of a group of asymptomatic individuals in order to detect a disease or to detect a condition with a high probability of developing into a disease. The National Cancer Institute (NCI) suggests that screening might decrease cancer morbidity because treatment for earlier-stage cancers is often less aggressive than that for more advanced cancers [1]. Only a few screening methods have evid