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        FDG PET/CT and Conventional Imaging Methods in Cancer of Unknown Primary: an Approach to Overscanning

        Neslihan Cetin Avci,Filiz Hatipoglu,Ahmet Alacacıoglu,Emine Ebru Bayar,Gonca Gul Bural 대한핵의학회 2018 핵의학 분자영상 Vol.52 No.6

        Purpose To compare the performance of fluorine-18 fluorodeoxyglucose positron emission tomography and computed tomography(FDG PET/CT) with conventional imaging methods (CIM), including computed tomography (CT), magnetic resonanceimaging (MRI), and mammography (MMG) in cancer of unknown primary (CUP). Methods A total of 36 patients with CUP, who referred to our clinic for a FDG PET/CTscan, were enrolled in this study. Thirty ofthe patients were also examined through either diagnostic CT/MRI and/or MMG. The diagnostic performance of both methodsfor the primary cancer location was analyzed. The results of FDG PET/CT and CIM were compared based on the standardreference of the histopathology and/or clinical and laboratory follow-up. Results The primary cancer locations were detected in 24 patients (66.6%, 24/36) by FDG PET/CT, whereas CIM identified thelocations in 16 patients (53.3%, 16/30). Sensitivity, specificity, PPV, NPV, and accuracy rates of the detection of the primarytumor localizations were as follows: 83, 70, 89, 58, and 79% for FDG PET/CT; 70, 62, 84, 42, and 68% for CIM, respectively. There was no statistical significance between modalities regarding any of the categories in 30 patients. Conclusion FDG PET/CT detected the primary tumors of the patients with CUP more than CIM did. However, the differencebetween them was not found to be statistically significant. It may be considered that FDG PET/CT scan can be performed as afirst-line tool in the initial diagnosis of the patients with CUP and to add radiodiagnostic imaging in selective cases.We concludethat if the first-line examination of a CUP patient has been already performed by a CIM and the result was negative orinconclusive, FDG PET/CT can be considered to avoid unnecessary imaging procedures.

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