Primeri bilinmeyen kanserde F(18)-FDG PET/BT tetkikinin tanıya katkısı

Amaç: Bu çalışmanın amacı, primeri bilinmeyen kanser (PBK) hastalarında 18F-florodeoksiglukoz pozitron emisyon tomografisi/bilgisayarlı tomografinin (F18-FDG PET/BT) klinik olarak tanıya katkısını değerlendirmektir. Yöntem: Retrospektif, kesitsel analiz çalışmasında Haziran 2014-Temmuz 2015 tarihleri arasında 124 PBK hastalarının F18-FDG PET/BT incelemesi yapıldı. Artmış 18F-FDG tutulum odağının histopatoloji ile korelasyonu değerlendirildi. F18-FDG PET/BT için tanısal doğruluk, duyarlılık, özgüllük, pozitif öngörü değeri ve negatif öngörü değerleri hesaplandı. Bulgular: F18-FDG PET/BT, yüksek F18-FDG tutulumu olan 56 hastada primer tümör odağını başarıyla saptadı (gerçek pozitif, % 45.2). 58 hastada histopatolojik ve klinik olarak primer tümör bulunamadı (gerçek negatif, % 46.8). 8 hastada yüksek F18-FDG uptake tutulumu olmasına karşın histopatolojik ve klinik olarak primer tümör kanıtı yoktu (yanlış pozitif, % 6.4). Sadece 2 hastada negatif F18-FDG PET/BT tarama sonuç bulunmasına karşın primer tümör histopatolojik olarak saptandı (yanlış negatif, % 1.6) primer yerleşim lokalizasyonu için negatif idi. Genel olarak tanısal doğruluk % 91.9, duyarlılık % 96.5, özgüllük % 87.8, pozitif öngörü değeri % 87.5, negatif öngörü değeri % 96.6, pozitif olabilirlik oranı % 7.9 ve negatif olabilirlik oranı % 0.04 olarak bulundu. Sonuç: PBK hastalarının tanısında F18-FDG PET/BT’nin yararlı olabileceği düşünülebilir.

The diagnostic contribution of (18)F-FDG PET/CT scan in cancer of unknown primary

Objective: The aim of the present study was to evaluate the clinically diagnostic contribution of 18Ffluorodeoxyglucosepositron emission tomography combined with computed tomography (18F-FDG PET/CT) inpatients with cancer of unknown primary (CUP).Method: The retrospective investigation, cross-sectional analysis of 124 18F-FDG PET/CT scans of patients with CUPbetween June 2014 and July 2015 was performed. The increased 18F-FDG uptake focus were assessed in correlationwith histopathology. The diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictivevalues were assessed for 18F-FDG PET/CT.Results: The 18F-FDG PET/CT successfully detected primary tumor in 56 patients with high 18F-FDG uptakeinvolvement (true positive, 45.2%). 58 patients whose final histopathology and clinically without evidence of a primarytumor (true negative, 46.8%). 8 patients whose final histopathologicallyand clinically without evidence of a primarytumor but high 18F-FDG uptake involvement (false positive, 6.4%). The 18F-FDG PET/CT scan results were negativefor primary site localization in only 2 patients with no 18F-FDG uptake involvement (false negative, 1.6%). Generally,the diagnostic accuracy was found to be 91.9%, sensitivity 96.5%, specificity 87.8%, positive predictive value 87.5%,negative predictive value 96.6%, positive likelihood ratio 7.9% and negative likelihood ratio 0.04%.Conclusions: It can be said that 18F-FDG PET/CT may be useful in the diagnosis of patients with CUP.

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