Clinical value of 18F-FDG-PET/CT in suspected serious disease with special emphasis on occult cancer View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-03

AUTHORS

Kamilla Bredlund Caspersen, Nikoletta Giannoutsou, Oke Gerke, Abass Alavi, Poul Flemming Høilund-Carlsen, Søren Hess

ABSTRACT

PURPOSE: Suspected serious disease (SSD) is a disease designation often given to patients with one or more non-specific symptoms of severe disease that could be due to cancer; the optimal diagnostic strategy is largely left to the clinician's discretion. Being a sensitive non-invasive whole-body imaging modality 18F-FDG-PET/CT may have a potential role in this cancer-prevalent group of patients to confirm or refute suspected malignancy. We aimed to investigate the diagnostic value of 18F-FDG-PET/CT in SSD using long-term follow-up as reference. METHODS: We retrospectively studied results obtained in all SSD patients referred for 18F-FDG-PET/CT at a single institution in 2010-2011 retrieving the following clinical data in all patients: journal entries, examinations, and evaluations made from 6 months before the scan and until the latest recorded entry. A true positive PET scan was a positive scan with a subsequently biopsy-confirmed diagnosis of cancer in the same target organ, whereas a false positive scan had no subsequent cancer diagnosis. A true negative PET scan was a negative scan without a cancer diagnosis during follow-up, whereas a false negative PET scan was one with a subsequently confirmed cancer diagnosis. RESULTS: Ninety-three patients, aged 67 years (range 25-89) were included and followed for up to 7.3 years (median 6). Of these, 21 [22.6% (95% CI 15.3-32.1)] turned out to have cancer. With 18F-FDG-PET/CT, the sensitivity was 81.0% (95% CI 60.0-92.3), specificity 76.4% (95% CI 65.4-84.7), positive predictive value 50% (95% CI 34.1-65.9), and negative predictive value 93.2% (95% CI 83.8-97.3). Five patients with negative scans were subsequently diagnosed with cancer. CONCLUSION: Cancer prevalence is substantial among patients with SSD. 18F-FDG-PET/CT is a promising option in this setting, in particular because a high negative predictive value equals a low incidence of cancer during follow-up. Further studies are needed to establish the role of 18F-FDG-PET/CT in SSD. More... »

PAGES

184-192

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s12149-018-01322-9

DOI

http://dx.doi.org/10.1007/s12149-018-01322-9

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1110765088

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30569441


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