Cancer screening with whole-body PET/CT for healthy asymptomatic people in Japan: re-evaluation of its test validity and radiation exposure.
Cancer screening with whole-body PET/CT for healthy asymptomatic people in Japan: re-evaluation of its test validity and radiation exposure.
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发表时间：
2007
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通讯作者：
N. Ghotbi;M. Iwanaga;A. Ohtsuru;Yoji Ogawa;S. Yamashita
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作者：
N. Ghotbi;M. Iwanaga;A. Ohtsuru;Yoji Ogawa;S. Yamashita
在日本，使用正电子发射断层扫描（PET）或PET/CT对无症状个体进行自愿癌症筛查正变得越来越普遍，尽管这种筛查的实用性仍然存在争议。本研究通过评估四个标准指标（敏感性、特异性、阳性/阴性预测值）和包括患病率在内的预测值，对日本健康人PET/CT癌症筛查的一般测试效度和有效辐射剂量进行了估计。从文献中收集CT和fdg相关剂量数据，然后外推到PET模型中心的扫描参数。我们估计，在50-59岁无症状的日本个体中，使用PET/CT自愿进行癌症筛查，其平均癌症患病率为0.5%，阳性预测值仅为3.3%。据估计，以60公斤体重计算，一次全身PET/CT扫描的总有效辐射剂量为6.34至9.48毫西弗。在日本进行PET/CT癌症筛查时，许多被筛查为假阳性的健康志愿者暴露在至少6.34毫西弗的辐射下，却没有得到任何真正的益处。有必要对健康人应用PET/CT的合理性进行更多的评估。
The use of Positron Emission Tomography (PET) or PET/CT for voluntary cancer screening of asymptomatic individuals is becoming common in Japan, though the utility of such screening is still controversial. This study estimated the general test validity and effective radiation dose for PET/CT cancer screening of healthy Japanese people by evaluating four standard indices (sensitivity, specificity, positive/negative predictive values), and predictive values with including prevalence for published literature and simulation-based Japanese data. CT and FDG-related dosage data were gathered from the literature and then extrapolated to the scan parameters at a model PET center. We estimated that the positive predictive value was only 3.3% in the use of PET/CT for voluntary cancer screening of asymptomatic Japanese individuals aged 50-59 years old, whose average cancer prevalence was 0.5%. The total effective radiation dose of a single whole-body PET/CT scan was estimated to be 6.34 to 9.48 mSv for the average Japanese individual, at 60 kg body weight. With PET/CT cancer screening in Japan, many healthy volunteers screened as false positive are exposed to at least 6.34 mSv without getting any real benefit. More evaluation concerning the justification of applying PET/CT for healthy people is necessary.