대한핵의학회지 (1967년~2009년)
Nucl Med Mol Imaging 2008;42(6)444~450
18F-FDG PET의 암 선별검사로서의 유용성
(The Usefulness of 18F-FDG PET as a Cancer Screening Test)
Author 고두흔1, 최준영2, 송윤미1, 이수진2, 김영환2, 이경한2, 김병태2, 이문규3,4,
Doo Heun Ko1, Joon Young Choi2, Yun-Mi Song1, Su Jin Lee2, Young Hwan Kim2, Kyung-Han Lee2, Byung-Tae Kim2, and Moon-Kyu Lee3,4
Affiliation 성균관의대 삼성서울병원 가정의학과1, 핵의학과2, 내과3, 건강의학센타4
Departments of 1Family Medicine, 2Nuclear Medicine and 3Internal Medicine, and 4Health Promotion Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Abstract

Purpose: The aim of this study was to evaluate the usefulness of whole body positron emission tomography (PET) using 18F-fluorodeoxyglucose (18F-FDG) for cancer screening in asymptomatic subjects. Materials and Methods: The subjects were 1,762 men and 259 women who voluntarily underwent 18F-FDG PET for cancer screening as a part of a routine health examination. Final diagnosis was decided by other diagnostic studies, pathological results or clinical follow-up for 1 year. Results: Of 2,021 subjects, 40 (2.0%) were finally proved to have cancer. Abnormal focal 18F-FDG uptake suggesting malignancy was found in 102 subjects (5.0%). Among them, 21 subjects (1.0%) were proved to have cancer. Other tests in the routine health examination could not find 9 of 21 cancers (42.9%) detected by PET. The sensitivity, specificity, positive predictive value, and negative predictive value of PET for cancer screening were 52.5%, 95.9%, 20.6%, and 99.0%, respectively. Pathologies of cancers missed on PET were adenocarcinoma (n=9; 3 colon cancers, 3 prostate cancers, 2 stomach cancers, and 1 rectal cancer), differentiated thyroid carcinoma (n=6), bronchioalveolar cell carcinoma (n=2), urinary bladder cancer (n=1), and melanoma (n=1). More than half of cancers which were not detected by PET were smaller than 1 cm in diameter. Conclusion: 18F-FDG PET might be useful for cancer screening in asymptomatic subjects due to its high specificity and negative predictive value and play a supplementary role to the conventional health check-up, but it could not replace due to limited sensitivity for urological cancers, small-sized tumors and some hypometaboic cancers. (Nucl Med Mol Imaging 2008;42(6):444-450)

Keyword Cancer screening, positron emission tomography, 18F-fluorodeoxyglucose
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