2008, Number 2
<< Back Next >>
Acta Med 2008; 6 (2)
Role of 18F-FDG PET/CT in the evaluation of unknown primary tumor and paraneoplastic syndrome; experience at the Hospital Angeles del Pedregal
Sánchez CNRJ, Serna MJA, Quiroz CÓ, Conde CY, Romo C, Valenzuela J, Ramírez AJL
Language: Spanish
References: 14
Page: 64-70
PDF size: 182.00 Kb.
ABSTRACT
Purpose: To assess the role of the
18F-FDG PET/CT study in detecting primary cancer lesions of an unknown primary tumor (CUP) and/or in patients with paraneoplastic syndrome.
Material and methods: 102 patients (58 women and 44 men; with ages ranging between 7-89 years) were included to be evaluated with
18F-FDG PET/CT; 6/102 patients (5.89%) were diagnosed with metastases of CUP. 96/102 patients (94.11%) were considered to have high clinical suspicion of cancer (49/96 had non-conclusive radiological findings).
18F-FDG PET/CT imaging with a whole-body field of view was performed in all patients. Contrast agents were administered orally and intravenously in all patients to ensure diagnostic CT data.
Results: We excluded 7 patients who denied/missed further diagnostic work-up after
18F-FDG PET/CT.
18F-FDG PET/CT depicted the primary tumor/malignancy in 44/95 (46.3%) patients. In 5/95 (5.2%) patients, the primary tumor site remained hidden. In 3/95 (3.1%) patients
18F-FDG PET/CT was false-positive (2 pulmonary and a hepatic benign lesions). In 43/95 (45.3%) patients
18F-FDG PET/CT did not reveal the suspected lesions as primary and malignancy were not found in these patients during clinical follow-up.
Conclusion: 18F-FDG PET/CT is a valuable diagnostic tool to be used in patients with suspected malignancies in both clinical scenarios (unknown primary tumors and paraneoplastic syndrome).
REFERENCES
Kart H. Bohuslavizki, Susanne Klutmann, Sabine Kröger. FDG PET Detection of unknown primary tumors. J Nucl Med 2000; 41: 816-822.
Delgado-Bolton RC, Fernández-Pérez C, González-Maté A, Carreras JL. Meta-analysis of the performance of 18F-FDG PET in primary tumors detection in unknown primary tumors. J Nucl Med 2003; 44: 1301-1314.
Jiménez-Vicioso A. Tumores de origen desconocido. In: J. Altamirano, G. Estrada, J. Carreras. PET y PET/CT en Oncología, México D.F.: Intersistemas S.A. de C.V.; 2005: 115-124.
Gutzeit A, Antoch G, Kühl H. Unknown primary tumors: Detection with dual-modality PET/CT- initial experience. Radiology 2005; 234: 227-234.
Haas I, Hoffmann TK, Engers R, Ganzer U. Diagnostic strategies in cervical carcinoma of an unknown primary (CUP). Eur Arch Otorhinolaryngol 2002; 259: 325-333.
Greco FA, Hainswoth JD. Cancer of unknown primary site. De Vita VT Jr, Hellman S, Rosenberg SA, editors. Cancer principles and practice of oncology. Fifth ed. Philadelphia: Lippincott-Raven Publishers; 1997: 2423-2443.
Reske SN, Kotzerke J. FDG PET for clinical use. Results of the 3rd German Interdisciplinary Consensus Conference, “Onko-PET III”, 21 July and 19 September 2000. Eur J Nucl Med 2001; 28: 1707-1723.
Beyer T, Townsend DW, Brun T. A combined PET/CT scanner for clinical oncology. J Nucl Med 2000; 41: 1369-1379.
AAssar OS, Fischbein NJ, Caputo GR. Metastatic head and neck cancer: Role and usefulness of 18F-FDG PET in locating occult primary tumors. Radiology 1999; 210: 177-181.
Mukherji SK, Drane WE, Mancuso AA. Occult primary tumors of the head and neck: Detection with 18F-FDG SPECT. Radiology 1996; 199: 761-766.
Delbeke D, Coleman RE. Procedure guideline for tumor imaging with 18F-FDG PET/CT. J Nucl Med 2006; 47: 885-895.
Schulthess G, Steinert H. Integrated PET/CT: Current applications and future directions. Radiology 2005; 238: 405-422.
Ziessman HA, O’Malley JP. Nuclear medicine: the requisites. 3rd edition. Philadelphia, PA: Elsevier Mosby; 2006.
Kostakoglu L, Hardoff R. PET/CT fusion imaging in differentiating physiologic from pathologic FDG uptake. Radiographics 2004; 24: 1411-1431.
Full text