At present, there is no ideal imaging modality for the diagnosis of distant metastases and second primary cancers in cancer patients. We aimed to assess the accuracy of whole-body PET/CT for the overall assessment of distant malignancies in patients with various cancers.
Studies about whole-body PET/CT for the detection of distant malignancies in cancer patients were systematically searched in MEDLINE and EMBASE. We determined sensitivities and specificities across studies, calculated positive and negative likelihood ratios, and constructed summary receiver operating characteristic curves using hierarchical regression models for whole-body PET/CT.
Across 41 studies (4,305 patients), the sensitivity and specificity of whole-body PET/CT were 0.93 (95% confidence interval [CI], 0.88-0.96) and 0.96 (95% CI, 0.95-0.96), respectively. Subgroup analysis showed that the sensitivity and specificity of whole-body PET/CT for various cancers, respectively, were as follows: head and neck cancer, 0.90 (95% CI, 0.83-0.95) and 0.95 (95% CI, 0.94-0.96); lung cancer, 0.91 (95% CI, 0.76-0.97) and 0.96 (95% CI, 0.94-0.98); breast cancer, 0.97 (95% CI, 0.93-0.99) and 0.95 (95% CI, 0.90-0.97); and cancer of digestive system, 0.92 (95% CI, 0.68-0.98) and 0.97 (95% CI, 0.91-0.99).
Whole-body PET/CT has excellent diagnostic performance for the overall assessment of distant malignancies in patients with various cancers, especially head and neck cancer, breast cancer, and lung cancer.
"A recent meta-analysis determined the accuracy of 18F-FDG PET/CT for detecting distant metastases or synchronous second cancers in more than 4,300 patients. On the basis of prospectively defined criteria, 41 published studies including patients with primary (n = 21 studies) or recurrent (n = 14 studies) cancers and patients with primary and recurrent cancers (n = 6) were included . In addition, the diagnostic performance of PET/CT was compared with that of conventional imaging in more than 800 patients. "
[Show abstract][Hide abstract] ABSTRACT: The discovery of the Warburg effect in the early twentieth century followed by the development of the fluorinated glucose analogue 18F-fluorodeoxyglucose (18F-FDG) and the invention of positron emission tomographs laid the foundation of clinical PET/CT. This review discusses the challenges and obstacles in clinical adoption of this technique. We then discuss advances in instrumentation, including the critically important introduction of PET/CT and current PET/CT protocols. Moreover, we provide evidence for the clinical utility of PET/CT for patient management and its potential impact on patient outcome, and address its cost and cost-effectiveness. Although this review largely focuses on 18F-FDG imaging, we also discuss a variety of additional molecular imaging approaches that can be used for cancer phenotyping with PET. Throughout this review we emphasize the critical contributions of CT to the strength of PET/CT.
[Show abstract][Hide abstract] ABSTRACT: Pneumonien sind sehr häufige Infektionserkrankungen mit einer relevanten Mortalität. Für eine Verbesserung der Prognose ist daher eine rasche und rationale Diagnostik essenziell. Radiologische Methoden sind ein integraler Bestandteil der Diagnostik, da nur so ein pulmonales Infiltrat nachgewiesen und die Diagnose gesichert werden kann. Als Standardmethode ist unverändert die konventionelle Röntgenuntersuchung des Thorax in 2 Ebenen anzusehen. Die Computertomographie kommt bei Immunsupprimierten und bei Patienten mit vorbestehenden Lungenerkrankungen zum Einsatz. Auch in der Abklärung therapierefraktärer Pneumonien sowie in der Differenzialdiagnostik bei Verdacht auf eine andere zugrunde liegende Erkrankung findet sie Anwendung. Zunehmende Bedeutung erlangt die Thoraxsonographie als eine rasch verfügbare, präzise Methode ohne Strahlenbelastung des Patienten.
Der Internist 07/2013; 54(7). DOI:10.1007/s00108-012-3239-7 · 0.31 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Accurate prognosis in patients with lung cancer is important for clinical decision making and treatment selection. The TNM staging system is currently the main method for establishing prognosis. Using this system, patients are grouped into one of four stages based on primary tumor extent, nodal disease, and distant metastases. However, each stage represents a range of disease extent and may not on its own be the best reflection of individual patient prognosis. (18)F-fluorodeoxyglucose-positron emission tomography ((18)F-FDG-PET) can be used to evaluate the metabolic tumor burden affecting the whole body with measures such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG). MTV and TLG have been shown to be significant prognostic factors in patients with lung cancer, independent of TNM stage. These metabolic tumor burden measures have the potential to make lung cancer staging and prognostication more accurate and quantitative, with the goal of optimizing treatment choices and outcome predictions.
Chinese Journal of Cancer Research 12/2013; 25(6):615-622. DOI:10.3978/j.issn.1000-9604.2013.11.10 · 1.94 Impact Factor
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