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Asian Pac J Cancer Prev. 2007 Jan-Mar;8(1):93-7.

Cancer screening with whole-body PET/CT for healthy asymptomatic people in Japan: re-evaluation of its test validity and radiation exposure.

Ghotbi N, Iwanaga M, Ohtsuru A, Ogawa Y, Yamashita S.

Takashi Nagai Memorial International Hibakusha Medical Center, Nagasaki University Hospital, Nagasaki City, Japan.

Abstract

The use of Positron Emission Tomography (PET) or PET/CT for voluntary cancer screening of asymptomatic individuals is becoming common in Japan, though the utility of such screening is still controversial. This study estimated the general test validity and effective radiation dose for PET/CT cancer screening of healthy Japanese people by evaluating four standard indices (sensitivity, specificity, positive/negative predictive values), and predictive values with including prevalence for published literature and simulation-based Japanese data. CT and FDG-related dosage data were gathered from the literature and then extrapolated to the scan parameters at a model PET center. We estimated that the positive predictive value was only 3.3% in the use of PET/CT for voluntary cancer screening of asymptomatic Japanese individuals aged 50-59 years old, whose average cancer prevalence was 0.5%. The total effective radiation dose of a single whole-body PET/CT scan was estimated to be 6.34 to 9.48 mSv for the average Japanese individual, at 60 kg body weight. With PET/CT cancer screening in Japan, many healthy volunteers screened as false positive are exposed to at least 6.34 mSv without getting any real benefit. More evaluation concerning the justification of applying PET/CT for healthy people is necessary.

翻译：在50－59岁的一般日本人群中，目前癌症患病率为0。5％，由此阳性预测值为3。3％，即PET－CT发现100例“癌症”／“阳性”只有3到4例是真的。