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Prognostic and diagnostic accuracy of [18F]FDG-PET/CT in 190 patients with carcinoma of unknown primary

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Abstract

Purpose

The aim of the study was to determine the accuracy of [18F]fluorodeoxyglucose (FDG) PET/CT in the search for the primary and the presence of a malignancy. The prognostic value of FDG-PET/CT information was tested.

Methods

A total of 190 patients were retrospectively analysed: 82 with histologically proven metastases (HPM) and 108 with clinical suspicion of the presence of a malignancy (CSM). The sensitivity and specificity were determined. Overall survival was calculated to evaluate the prognostic value of the FDG-PET/CT findings.

Results

In the search for the primary, the sensitivity and specificity were 62.0% and 81.9%, respectively. In the search for the presence of a malignancy, the sensitivity and specificity were 93.6% and 85.7%, respectively. Between the HPM and CSM groups, no significant difference in sensitivity and specificity was found either in the search for the primary or in the search for the presence of a malignancy. No significant difference in the sensitivity and specificity was found between 78 patients who were investigated by contrast-enhanced FDG-PET/CT and the remaining patients. A significantly shorter overall survival was found among patients with positive FDG-PET/CT findings compared with patients with negative findings (p = 0.00001); no significant difference in survival was found between the HPM and the CSM group (p = 0.770).

Conclusion

FDG-PET/CT imaging is very helpful in the search for the presence of a malignancy in patients with carcinoma of unknown primary syndrome. FDG-PET/CT is less accurate in identifying exactly the site of a primary. Discovery of a hypermetabolic lesion was associated with the worst survival rate.

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Authors and Affiliations

  1. PET Center, Na Homolce Hospital, Roentgenova 2, 150 30, Prague 5, Czech Republic

    Pavel Fencl, Otakar Belohlavek, Magdalena Skopalova, Monika Jaruskova, Iva Kantorova & Katerina Simonova

Authors
  1. Pavel Fencl
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  2. Otakar Belohlavek
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  3. Magdalena Skopalova
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  4. Monika Jaruskova
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  5. Iva Kantorova
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  6. Katerina Simonova
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Correspondence to Pavel Fencl.

Additional information

This study was cited in the Highlights Lecture on the EANM Congress, Athens 2006.

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Fencl, P., Belohlavek, O., Skopalova, M. et al. Prognostic and diagnostic accuracy of [18F]FDG-PET/CT in 190 patients with carcinoma of unknown primary. Eur J Nucl Med Mol Imaging 34, 1783–1792 (2007). https://doi.org/10.1007/s00259-007-0456-8

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  • DOI: https://doi.org/10.1007/s00259-007-0456-8

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