"The unexpected abnormalities we followed up on were significant," said the study's lead author, Harry Agress Jr., M.D., who is director of nuclear medicine at Hackensack University Medical Center's PET center. "Approximately 71 percent of the lesions that were confirmed with biopsy were either malignant or premalignant. Typically, these cancers were not symptomatic and were unrelated to the primary cancer for which the scan was performed."
The researchers evaluated 1,750 PET scans of known or suspected cancers to determine the importance and malignant potential of additional, unexpected abnormal findings encountered during routine PET evaluation. They identified 58 abnormalities in 53 patients. Most abnormalities were found in the colon, while others were located in the breast, fallopian tube, uterus, gallbladder, larynx, ovary, bone and thyroid.
Forty-five abnormalities were further evaluated with additional computed tomography (CT), magnetic resonance imaging and/or mammography, and 42 were subsequently biopsied. Thirty (71 percent) of the biopsied abnormalities were either malignant or premalignant tumors that were unrelated to the primary tumor already under study.
Follow-up is crucial when the PET evaluation reveals incidental findings. "If we had not pursued the abnormalities disclosed by PET, these patients would only have been treated for their known cancer while another malignancy remained undiagnosed." Dr. Agress said. "Patients reported no symptoms in 92 percent of the incidental findings that we confirmed, and the other 8 percent were symptomatic only in retrospect or had been unsuccessfully worked up for symptoms prior to the PET scan."
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Contact: Maureen Morley
mmorley@rsna.org
630-590-7754
Radiological Society of North America
27-Jan-2004