Screening for Cancer with PET and PET/CT: Potential and Limitations

摘要: Screening for cancer remains a very emotional and hotly debated issue in contemporary medical practice. An analysis of published data reveals multitude opinions based on limited amount reliable data. Even breast screening, which is now widely practiced the United States many European countries, there continuing controversy regarding appropriate age limits screening mammography and, fact, concerning value itself. Similarly, no agreement as to whether lung or prostate meaningful currently practiced. Recommendations decisions should be data, not good intention, assumptions, speculation. Therefore, we first explain underlying principles premises then briefly discuss current controversies breast, prostate, cancers. Recently, some authors advocated CT, PET, PET/CT whole-body without support from We potential financial, legal, radiation safety implications associated with CT PET screening. conclude available that neither nor warranted. Far providing desirable binary answer (presence absence cancer), nonselected populations procedures frequently yield equivocal indeterminate findings require further evaluation, costs complications. The clinical statistical relevance occasionally detected cancers likely too low justify population-wide efforts these 2 imaging modalities. Ultimately, true utility, lack thereof, can assessed only prospective randomized trial. Because prohibitive required length follow-up, it unlikely such trial will ever conducted. Rather than spending time resources studies, practitioners continue using diagnosing, staging, restaging monitoring treatment effects. Researchers also investigate utility surveillance selected groups patients who have cancer, completed curative treatment, but remain at high risk recurrent disease.