Improved detection of second primary cancer using integrated [18F] fluorodeoxyglucose positron emission tomography and computed tomography for initial tumor staging.

Abstract

PURPOSE:

This study evaluated prospectively the value of integrated whole-body positron emission tomography and computed tomography (PET/CT) using [18F] fluorodeoxyglucose (FDG) in detecting a second primary cancer at the time of the initial staging in comparison with a conventional staging work-up (CSW).

METHODS:

The participants were 547 patients diagnosed with cancer who underwent FDG PET/CT imaging for the initial staging. An additional diagnostic evaluation was performed when there were abnormal findings indicative of a second primary cancer on either PET/CT or CSW considering the site and the biologic behavior of the alleged primary tumor.

RESULTS:

A total of 27 second primary malignant tumors were identified in 26 of the 547 patients (4.8%). FDG PET/CT found 45 lesions indicative of a second primary cancer, of which 24 lesions were proved to be a second primary cancer, seven were clinically unexpected metastases, and 14 lesions were benign. Therefore, sensitivity and positive predictive value of FDG PET/CT in detecting a second primary cancer or an unexpected metastasis were 91% (31 of 34) and 69% (31 of 45), respectively. In contrast, CSW could not identify 16 second primary cancers and one metastatic lesion.

CONCLUSION:

FDG PET/CT at the time of the initial staging is useful for screening a second primary cancer with a high sensitivity. An additional diagnostic work-up is essential when abnormal findings, which are indicative of a second primary cancer, are obtained on PET/CT images to rule out the presence of either a second primary cancer or an unexpected metastasis.

• Authors: Joon Young Choi, Kyung Soo Lee, O Jung Kwon, Young Mog Shim, Chung-Hwan Baek, Keunchil Park, Kyung-Han Lee, Byung-Tae Kim
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 23 Issue 30 Pg. 7654-9 (Oct 20 2005) ISSN: 0732-183X [Print] United States
• PMID: 16234527 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Radiopharmaceuticals
• Fluorodeoxyglucose F18

Topics

• Aged
• Aged, 80 and over
• Female
• Fluorodeoxyglucose F18
• Humans
• Male
• Middle Aged
• Neoplasm Staging
• Neoplasms (diagnosis, diagnostic imaging)
• Neoplasms, Second Primary (diagnosis, diagnostic imaging)
• Prospective Studies
• Radiopharmaceuticals
• Sensitivity and Specificity
• Tomography, Emission-Computed
• Tomography, X-Ray Computed