Performance profile of FDG-PET and PET/CT for cancer screening on the basis of a Japanese Nationwide Survey
Performance profile of FDG-PET and PET/CT for cancer screening on the basis of a Japanese Nationwide Survey
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DOI：
10.1007/s12149-007-0061-8
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发表时间：
2007-11-01
影响因子：
2.6
通讯作者：
Inoue, Tomio
中科院分区：
文献类型：
--
作者：
Minamimoto, Ryogo;Senda, Michio;Inoue, Tomio
目的调查日本18氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）癌症筛查的现状，并描述其性能特征。方法“FDG-PET癌症筛查”定义为FDG-PET或正电子发射断层扫描和计算机断层扫描（PET/CT）扫描结合或不结合其他检查，用于健康受试者的癌症筛查。我们在2005财政年度向99家进行FDG-PET检查的机构发送了关于FDG-PET癌症筛查的问卷。从99个设施中的68个获得了答复，其中46个设施进行了FDG-PET癌症筛查。接受FDG-PET癌症筛查的受试者总数为50558人。从46家机构中的38家机构，获得了FDG-PET阳性受试者和/或进行了一项或多项联合筛查试验的可靠全面检查结果，并将其转诊进行进一步评价。结果2005年日本46家PET中心共对50 558名健康受试者进行了FDG-PET（包括PET/CT）扫描，并进行了其他癌症筛查。9.8%的病例因阳性结果提示可能的癌症而需要进行彻底检查。分析38个PET中心的43996例病例，获得详细信息，发现500例癌症（1.14%），其中PET阳性0.90%，阴性0.24%，PET的相对灵敏度为79.0%。甲状腺癌、结肠/直肠癌、肺癌和乳腺癌最常见（分别为107、102、79和35例），PET灵敏度较高（88%、90%、80%和92%）。PET显示总体阳性预测值为29.0%。PET/ CT的检出率、敏感性和阳性预测值均优于专用PET（P < 0.01）。结论：基于日本全国范围的调查，我们能够阐明“FDG-PET用于癌症筛查”的性能概况。拥有PET的设施数量正在稳步增加，这突出表明有必要通过对大量受试者进行长期调查，尽快评估“FDG-PET癌症筛查”的有用性。
Objective The aim of this study is to survey the situation of F-18- fl uorodeoxyglucose-positron emission tomography (FDG- PET) cancer screening in Japan and to describe its performance profile.Methods " FDG- PET for cancer screening" was defi ned as FDG-PET or positron emission tomography and computed tomography (PET/CT) scan with or without other tests performed for cancer screening of healthy subjects. We sent questionnaires regarding FDG-PET cancer screening to 99 facilities in which FDG- PET tests were performed during the fi scal year 2005. Replies were obtained from 68 of the 99 facilities, of which 46 facilities performed FDG-PET cancer screening. The total number of subjects who underwent FDG- PET cancer screening was 50 558. From 38 of 46 facilities, reliable results of thorough examinations were obtained for the subjects who were positive by FDG-PET and/ or one or more of the combined screening tests was performed and were referred for further evaluation. The total number of subjects in these 38 facilities amounted to 43 996.Results A total of 50 558 healthy subjects underwent FDG-PET (including PET/CT) scanning with or without other tests for cancer screening in 46 PET centers during the fi scal year of 2005 in Japan. Thorough examination was indicated for 9.8% of the cases as a result of positive fi ndings suggesting possible cancer. On analyzing 43 996 cases from 38 PET centers from which detailed information was obtained, 500 cases of cancers (1.14%) were found, of which 0.90% were PET positive and 0.24% were PET negative, resulting in the relative sensitivity of PET being 79.0%. Cancers of the thyroid, colon/ rectum, lung, and breast were most frequently found (107, 102, 79, and 35 cases, respectively) with high PET sensitivity (88%, 90%, 80%, and 92%). PET showed an overall positive predictive value of 29.0%. PET/ CT had a better detection rate, sensitivity, and positive predictive value than dedicated PET (P < 0.01).Conclusions We were able to clarify the performance profi le of " FDG- PET for cancer screening" on the basis of a Japanese nationwide survey. The number of facilities possessing PET is increasing steadily, highlighting the necessity of evaluating the usefulness of " FDG- PET cancer screening" as soon as possible by undertaking long-term investigations of large series of subjects.