Do not perform PET/CT for cancer screening in healthy subjects.

Do not perform PET/CT for cancer screening in healthy subjects.

Type of practice

Imaging

Age

Adult

Topic Area

Hospital Internal Medicine

The probability of diagnosing a malignant neoplasm with PET/CT in asymptomatic patients is less than 1%. Many of these cases are indolent neoplasms, which do not benefit from early therapy, or advanced stage tumors (for example tumors starting from the pancreas). The number of false positive tests and incidental findings (overdiagnosis – especially for the detection of head and neck tumors) is preponderant and this leads to the use of additional tests, biopsies and surgical procedures that are not useful for the prognosis and are often harmful, in addition to excessive costs for the healthcare system. On the other hand, in symptomatic patients with suspicion of malignant neoplasm, PET/CT appears to be a useful method for cancer staging and for post-treatment control. It is therefore necessary to apply these imaging methods only in well-defined contexts and within shared protocols.

Sources

1. Minamimoto R, Senda M, Jinnouchi S, et al. The current status of FDG-PET cancer screening program in Japan, based on a 4-year (2006-2009) nationwide survey. Ann Nucl Med 2013; 27:46-57. doi: 10.1007/s12149-012-0660-x.
2. Minamimoto R, Senda M, Jinnouchi S, et al. Detection of breast cancer in an FDG-PET cancer screening program: results of a nationwide Japanese survey. Clin Breast Cancer 2015; 15:e139-46. doi: 10.1016/j.clbc.2014.09.008.
3. Chan HP, Liu WS, Liou WS, et al. Comparison of FDG-PET/CT for cancer detection in populations with different risks of underlying malignancy. In Vivo 2020; 34:469-78. doi: 10.21873/invivo.11797.
4. Lee JW, Kang KW, Paeng JC, et al. Cancer screening using 18F-FDG PET/CT in Korean asymptomatic volunteers: a preliminary report. Ann Nucl Med 2009; 23:685-691. doi: 10.1007/s12149-009-0291-z.

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