[Importance of nuclear medicine diagnostics in CUP syndrome.]

[Importance of nuclear medicine diagnostics in CUP syndrome.]
Radiologe. 2014 Jan 22;
Authors: Winter MC, Haberkorn U, Kratochwil C
Abstract
CLINICAL/METHODICAL ISSUE: The diagnostic work-up in patients with carcinoma of unknown primary (CUP) syndrome is extensive, highly time-consuming and cost-intensive and ultimately often fails to detect a primary site.
STANDARD RADIOLOGICAL METHODS: In this context chest X-ray and computed tomography (CT) have been used as standard imaging modalities in CUP syndrome.
METHODOLOGICAL INNOVATIONS: Since the introduction of positron emission tomography (PET) evaluation of tumor vitality has become possible. Furthermore, PET-CT hybrid scanners allow the combination of functional and morphological imaging.
PERFORMANCE: Several meta-analyses have reported an additional overall detection rate between 24.5 % and 44 % by either PET or PET-CT. Metastatic localization (cervical versus extracervical) did not influence the performance. The sensitivity was usually high (> 80 %) but specificity was moderate ranging from 68 % to 88 % at best. If mentioned, the results obtained by fluorodeoxyglucose (FDG)-PET significantly changed the clinical management in approximately one third of the patients studied. In a direct comparison with PET alone, PET-CT did not depict significantly more primary tumors but was able to reduce false positive findings.
ACHIEVEMENTS: To determine the re...

Source: Der Radiologe - January 22, 2014 Category: Radiology Authors: Winter MC, Haberkorn U, Kratochwil C Tags: Radiologe Source Type: research