Ken Ono MD, Presenter: Nothing to Disclose

Tsuyoshi Yoshida MD, PhD, Abstract Co-Author: Nothing to Disclose

Reiji Ochiai MD, PhD, Abstract Co-Author: Nothing to Disclose

Mami Kitagawa MD, Abstract Co-Author: Nothing to Disclose

Hisashi Kobayashi MD, PhD, Abstract Co-Author: Nothing to Disclose

Junichi Omagari MD, Abstract Co-Author: Nothing to Disclose

Positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) is a less-invasive method for surveying the whole body and detecting various cancers. In this study, we examined the potential application and limitations of using whole-body PET for cancer screening in asymptomatic individuals.

Between April 21, 2003 and August 31, 2004, whole-body FDG PET was used as a cancer screening modality in 4736 healthy subjects. The subjects consisted of 2780 men and 1956 women, with a mean age of 56.1 years (22-90 years). PET was performed in conjunction with conventional examinations including a medical questionnaire, laboratory studies, ultrasonography and/or chest CT. The PET results were compared with the screening outcomes. The average injection dose of FDG was 180MBq (3.7MBq/kg weight). The whole body PET scan was started at one-hour post injection to collect both the transmission and emission data using a PET camera ( Advance NXi, GEMS.). A regional delayed scan was added at two hours post injection in cases with a suspicious focal uptake.

Within 7 months after screening, malignant tumors were discovered in 102 of the 4736 participants (2.15%). The PET findings were true-positive in 75 of the 102 cancers (70.8%). Most of the 75 patients underwent potentially curative surgery; thus a wide variety of cancers were detected by PET at potentially curable stages. However, there were 31 false-negative findings (29.2%). The lesions were located as follows: 5 in the lung; 4 in the bladder; 4 in the prostate; 3 in the stomach; 3 in the colon; 3 in the kidney; 3 in the Head and Neck; 3 in the breast; 1 in the thyroid gland ; 1 in the esophagus; 1 in the liver; and 1 in the gall bladder.

The detection rate of cancer with FDG-PET in asymptomatic individuals was 2.15% which was relatively higher than the rate observed for other modalities. FDG PET imaging therefore has a potential to detect a wide variety of cancers at potentially curable stages. However, the false-negative findings were rather high. Therefore, other conventional examinations are also needed in conjunction with FDG-PET to effectively conduct cancer screening.

Ono, K, Yoshida, T, Ochiai, R, Kitagawa, M, Kobayashi, H, Omagari, J, The Application and Limitations of Positron Emission Tomography Imaging for Cancer Screening.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4415650.html