18F‐FDG PET/CT as a Diagnostic Tool in Patients with Extracervical Carcinoma of Unknown Primary Site: A Literature Review

• Published in: The oncologist (Dayton, Ohio) Ohio), 2011-04, Vol.16 (4), p.445-451
• Main Authors: Moller, Anne Kirstine Hundahl, Loft, Annika, Berthelsen, Anne Kiil, Damgaard Pedersen, Karen, Graff, Jesper, Christensen, Charlotte Birk, Perell, Katharina, Petersen, Bodil Laub, Daugaard, Gedske
• Format: Article
• Language: English
• Subjects: 18F‐FDG PET/CT; Cancer Imaging; Carcinoma of unknown primary site; Diagnostic tool; Extracervical carcinoma of unknown primary; Fluorodeoxyglucose F18; Humans; Lung Neoplasms - diagnosis; Lung Neoplasms - diagnostic imaging; Neoplasms, Unknown Primary - diagnosis; Neoplasms, Unknown Primary - diagnostic imaging; Positron-Emission Tomography - methods; Tomography, Emission-Computed - methods
• ISSN: 1083-7159; 1549-490X
• DOI: 10.1634/theoncologist.2010-0189

Background. Carcinoma of unknown primary (CUP) represents a heterogeneous group of metastatic malignancies for which no primary tumor site can be identified after extensive diagnostic workup. Failure to identify the primary site may negatively influence patient management. The aim of this review was to evaluate 18F‐fluorodeoxyglucose positron emission tomography/computed tomography (18F‐FDG PET/CT) as a diagnostic tool in patients with extracervical CUP. Materials and Methods. A comprehensive literature search was performed and four publications were identified (involving 152 patients) evaluating 18F‐FDG PET/CT in CUP patients with extracervical metastases. All studies were retrospective and heterogeneous in inclusion criteria, study design, and diagnostic workup prior to 18F‐FDG PET/CT. Results. 18F‐FDG PET/CT detected the primary tumor in 39.5% of patients with extracervical CUP. The lung was the most commonly detected primary tumor site (∼50%). The pooled estimates of sensitivity, specificity, and accuracy of 18F‐FDG PET/CT in the detection of the primary tumor site were 87%, 88%, and 87.5%, respectively. Conclusions. The present review of currently available data indicates that 18F‐FDG PET/CT might contribute to the identification of the primary tumor site in extracervical CUP. However, prospective studies with more uniform inclusion criteria are required to evaluate the exact value of this diagnostic tool. 摘要 背景. 原发灶不明癌（Carcinoma of unknown primary，CUP）是经全面检查，不能确定原发灶的一类异质性的恶性转移瘤。不能明确原发部位对患者的治疗造成负面影响，本综述旨在评估18F‐FDG PET/CT作为诊断工具，在颈外CUP患者中的应用价值。 材料和方法. 全面检索文献，有4篇公开发表的文献评估了18F‐FDG PET/CT在颈外CUP中的价值（共152例）。所有研究均为回顾性，不仅纳入标准、研究设计不同，而且18F‐FDG PET/CT检查前接受的诊断性检查也各异。 结果. 18F‐FDG PET/CT可检出39.5%的颈外CUP患者的原发肿瘤，肺部是最常见的部位（占～50%）。18F‐FDG PET/CT检出原发灶的敏感性、特异性和精确性分别为87%、88%和87.5%。 结论. 目前可获得的综述资料表明，18F‐FDG PET/CT可能有助于明确颈外CUP的原发灶，然而，有必要采用更加统一的纳入标准进行前瞻性研究，以评估这种诊断工具的确切价值。 18F‐fluorodeoxyglucose positron emission tomography/computed tomography was evaluated as a diagnostic tool in patients with extracervical cancer of unknown primary.