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Detection of colorectal cancer and adenomas by FDG-PET cancer screening program: results based on a nationwide Japanese survey

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Abstract

Purpose

The aim of this study was to analyze the detection rate for CRC and adenomas for asymptomatic subjects in Japan by FDG-PET cancer screening program carried out between 2006 and 2009.

Methods

The “FDG-PET cancer screening program” included both PET and positron emission tomography with computed tomography (PET/CT) with or without other screening tests. A total of 154,783 asymptomatic subjects underwent FDG-PET cancer screening program; we analyzed the 1,808 cases with findings from any detection method that indicated suspected CRC.

Results

Among the 1,808 cases, the number of cases verified as CRC and adenoma was 394 and 679, respectively. The sensitivity and positive predictive value (PPV) of FDG-PET were 86.0 and 31.7 % for CRC, and 63.6 and 63.8 % for CRC and adenoma. The sensitivity and PPV of fecal occult blood test (FOBT) for CRC were lower than those of FDG-PET, but higher for adenoma. Therefore, FDG-PET and FOBT were complementary for screening for CRC, and CRC and adenoma. The majority of CRC detected by the FDG-PET imaging was UICC stage 0 or I, however, detection of smaller or less invasive cancer was limited.

Conclusion

The FDG-PET screening program in Japan has detected CRC at an early stage and adenomas as premalignant lesions. A combination of FDG-PET and FOBT yields the best results if the intent is to detect either CRC or adenoma. However, it is absolutely clear that an FDG-PET cancer screening program cannot detect all colon lesions.

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Acknowledgments

This work was supported by the National Cancer Center Research and Development Fund 23-A-25, Japanese Council of PET Imaging: working group on epidemiology study for PET cancer screening, the PET cancer screening research group of Yokohama City University. The authors would like to express our sincere appreciation and gratitude to Sachiko Yanagida and Yoshihide Nakamura from Japan Radioisotope Association for management of this survey.

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Correspondence to Ryogo Minamimoto.

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Minamimoto, R., Senda, M., Jinnouchi, S. et al. Detection of colorectal cancer and adenomas by FDG-PET cancer screening program: results based on a nationwide Japanese survey. Ann Nucl Med 28, 212–219 (2014). https://doi.org/10.1007/s12149-013-0797-2

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  • DOI: https://doi.org/10.1007/s12149-013-0797-2

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