Clinical value of whole-body F-18 fluorodeoxyglucose positron emission tomography/computed tomography in patients with carcinoma of unknown primary

Authors

  • Guohui Wang,

    1. Department of Medical Imaging and Interventional Radiology, Cancer Center and State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, China
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  • Yaopan Wu,

    1. Department of Medical Imaging and Interventional Radiology, Cancer Center and State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, China
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    • Yaopan Wu contributed equally to this work.
  • Weidong Zhang,

    1. Department of Medical Imaging and Interventional Radiology, Cancer Center and State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, China
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  • Jiayao Li,

    1. Department of Medical Imaging and Interventional Radiology, Cancer Center and State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, China
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  • Peihong Wu,

    1. Department of Medical Imaging and Interventional Radiology, Cancer Center and State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, China
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  • Chuanmiao Xie

    Corresponding author
    • Department of Medical Imaging and Interventional Radiology, Cancer Center and State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, China
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  • G Wang PhD, MD; Y Wu MD; W Zhang PhD, MD; J Li MD; P Wu MD; C Xie MD.
  • Conflict of interest: None.

Correspondence

Prof Chuanmiao Xie, Department of Medical Imaging and Interventional Radiology, Cancer Center and State Key Laboratory of Oncology in South China, Sun Yat-sen University, no. 651, Dongfeng Road, East, Guangzhou 510060, Guangdong, China.

Email: xiechuanmiao@126.com

Abstract

Introduction

The purpose of the study is to investigate the clinical value of F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in detecting the primary sites in patients with carcinoma of unknown primary (CUP).

Methods

The reports of FDG PET/CT scans of 164 patients with CUP syndrome in consecutive 2589 patients referred to our department from January 2006 to June 2010 were retrospectively reviewed. The final results were obtained from the pathologic reports, other imaging modalities diagnoses and clinical follow-up data.

Results

There were 142 cases in the results analysis, as 19 patients were lost to follow-up and three patients were excluded. FDG PET/CT successfully detected primary tumours in 67 (47.2%) out of 142 patients. Among this group, 53 were pathologically proved and 17 patients were confirmed by clinical follow-up. The primary sites of 38 (56.7%) were in lung, eight (11.9%) in nasopharynx and 13 (19.4%) in digestive system. Six patients were misdiagnosed by FDG PET/CT scan. FDG PET/CT could not detect the primary lesion in 66 patients, and three primary tumours were identified by conventional work-up after negative FDG PET/CT scan. The accuracy, sensitivity and specificity of FDG PET/CT scan in detecting the primary site in this study were 93.7%, 95.7% and 91.7%, respectively. FDG PET/CT scan changed the medical management of about 33.8% of 142 CUP patients.

Conclusion

FDG PET/CT whole-body imaging is a valuable tool in detecting the primary tumour of patients with CUP site.

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