Performance profile of a FDG-PET cancer screening program for detecting gastric cancer: results from a nationwide Japanese survey

Jpn J Radiol. 2014 May;32(5):253-9. doi: 10.1007/s11604-014-0294-0. Epub 2014 Feb 23.

Abstract

Purpose: It has been reported that gastric cancer is the sixth most common cancer found during the (18)F-fluorodeoxyglucose-positron emission tomography (FDG-PET) cancer screening program, which is defined as cancer screening of asymptomatic subjects using FDG-PET(/CT) (in combination with other screening tests or not). The aim of this study was to analyze the detection rate and the effectiveness of the FDG-PET cancer screening program at detecting gastric cancer between 2006 and 2009 in Japan.

Materials and methods: A total of 153,775 asymptomatic subjects (92,255 men, 61,520 women) between 30 and 80 years old underwent the FDG-PET cancer screening program. Of these, we analyzed 790 cases with findings of possible gastric cancer in any screening test.

Results: The number of cases who were verified to have gastric cancer was 124. Among these, only 47 cases were detected by FDG-PET, which resulted in a relative sensitivity of 37.9% and a positive predictive value of 33.6%. The relative sensitivity of FDG-PET was much lower than those of gastric endoscopy and the serum pepsinogen test.

Conclusion: The FDG-PET screening program in Japan detected some cases of early-stage gastric cancer, but this was not achieved using FDG-PET alone but in combination with gastric endoscopy. Gastric endoscopy should be included in FDG-PET cancer screening programs to screen for gastric cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / blood
  • Early Detection of Cancer / methods
  • Female
  • Fluorodeoxyglucose F18
  • Gastroscopy
  • Humans
  • Japan / epidemiology
  • Male
  • Mass Screening*
  • Middle Aged
  • Neoplasm Staging
  • Pepsinogen A / blood
  • Positron-Emission Tomography / methods*
  • Predictive Value of Tests
  • Radiopharmaceuticals
  • Retrospective Studies
  • Sensitivity and Specificity
  • Stomach Neoplasms / diagnostic imaging*
  • Stomach Neoplasms / pathology

Substances

  • Biomarkers, Tumor
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • Pepsinogen A