Journal article
Role of FDG PET/CT for detection of primary tumor in patients with extracervical metastases from carcinoma of unknown primary
Clinical imaging, Vol.78, pp.262-270
10/01/2021
DOI: 10.1016/j.clinimag.2021.06.022
PMID: 34174653
Abstract
Aim: To explore the diagnostic performance of F-18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) to detect the primary tumor site in patients with extracervical metastases from carcinoma of unknown primary (CUP). We evaluated patient outcomes as overall survival (OS).
Materials and methods: In a single-center, retrospective study (2005-2019), patients with extracervical metastases from CUP underwent FDG PET/CT to detect primary tumor sites. The final diagnosis was based on histopathology/or clinical follow-up of at least 12 months.
Results: A total of 83 patients [Male 41 (49%), mean age 59 +/- 14 years, range: 32-83 years] fulfilled the inclusion/exclusion criteria and were enrolled for analysis. The primary tumor was detected in 36 out of 83 (43%) patients based on histopathology/or clinical follow-up. PET/CT suggested the primary tumor site in 39 (47%) patients with diagnostic accuracy of 87%, sensitivity 89%, specificity 85%, PPV 82%, NPV 91% and detection rate 39%. Patients with oligometastases (<3) (2.16 years, 1.04-2.54) and primary unidentified (1 year, 0.34-2.14) had longer median survival time compared to the patients with multiple metastases (0.67 years, 0.17-1.58, p = 0.009) and primary identified (0.67 years,0.16-1.33, p = 0.002). The SUVmax of the primary or metastatic lesions with maximum uptake was not significantly related to survival.
Conclusions: PET/CT could reveal the primary tumor site in 39% of the patients. It demonstrated the metastatic disease burden and distribution in patients with 'primary obscured', which directs management. Patients with multiple metastases and primary identified had a poorer prognosis. In patients with primary unidentified after PET/CT, a further search was futile.
Details
- Title: Subtitle
- Role of FDG PET/CT for detection of primary tumor in patients with extracervical metastases from carcinoma of unknown primary
- Creators
- Neetu Soni - University of IowaManish Ora - Sanjay Gandhi Post Graduate Institute of Medical SciencesPritish Y. Aher - University of Iowa Hospitals and ClinicsPrabhakar Mishra - SGPGIMS, Dept Biostat & Hlth Informat, Lucknow, Uttar Pradesh, IndiaRavishankar Pillenahalli Maheshwarappa - University of IowaSarv Priya - University of IowaMichael M. Graham - Radiology - Division of Nuclear Medicine, Radiation Oncology, 3863 JPP, Iowa City, IA 52242, USA
- Resource Type
- Journal article
- Publication Details
- Clinical imaging, Vol.78, pp.262-270
- Publisher
- Elsevier
- DOI
- 10.1016/j.clinimag.2021.06.022
- PMID
- 34174653
- ISSN
- 0899-7071
- eISSN
- 1873-4499
- Number of pages
- 9
- Language
- English
- Date published
- 10/01/2021
- Academic Unit
- Radiology; Radiation Oncology
- Record Identifier
- 9984312973402771
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