Detection of additional primary malignancies: the role of CT and PET/CT combined with multiple percutaneous biopsy

Abstract

Objective: To evaluate the imaging findings of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and computed tomography (CT) in patients with additional primary tumors, correlating the results with those of the method used in order to elucidate the diagnosis and of the pathology reports. Materials and Methods: We retrospectively analyzed the medical records, pathology reports and images of 11 patients who underwent CT, 18F-FDG PET/CT, or both. We included patients with at least two tumors, with confirmed distinct histopathological profiles, at different sites. Patients in whom there was no diagnostic confirmation were excluded, as were those in whom the additional lesion was suspected of being a metastasis of the first. Results: New primary malignancies were identified in 11 patients, one new tumor being found in 10 and two new tumors being found in 1. The confirmed sites of the additional malignancies were the lung, kidney, prostate, jejunum, and breast. Single or multiple percutaneous biopsies were performed in 10 patients, and 1 patient underwent a surgical procedure for diagnostic and therapeutic purposes. The tumors were metachronous in 6 cases and synchronous in 5. Conclusion: CT and 18F-FDG PET-CT combined with multiple percutaneous biopsy could facilitate the diagnosis of additional lesions, thus optimizing the treatment and follow-up of the affected patients.

Detection of additional primary malignant tumor in cancer survivors: the use of PET/CT for image-guided biopsy

“…The detection rate in this study (3.26%) in relatively in concordance to Ali et al [10], who had shown similar detection rate 13 out of 273 patients (4.76%) with the lower PPV of 56.5% and sensitivity of 89.2% and discordance to Servente et al [11] who showed less detection rate (1.2%, 49/4086) and Tibana and Lee [3,12] who had shown lesser detection rate (1.1).…”

“…In this study, the foremost common location of the second primary tumor was colon (n = 5) and lung (n = 5) in concordance to Servente et al [11] who histologically confirmed second primary in colon (n = 18), lung (n = 6), breast (n = 6), and in discordance to study of Tibana et al [3] who found most common sites of the additional malignancies were the lung (n = 4), kidney (n = 3), and prostate (n = 2).…”

“…Development of additional primary cancers may be attributed to remote side effects of chemotherapy and/or radiation therapy, persisting effect of genetic defects, hormonal factors, and environmental influences and behavioral risk factors [1,2]. Surveillance, Epidemiology, and End Results (SEER) Program and the International Association of Cancer Registries and International Agency for Research on Cancer (IACR/IARC) define multiple primary tumors as more than one, synchronous or metachronous lesion in the same individual with distinct histopathology [3]. Overall reported frequency of multiple primary cancers varies between 2.4% and 17% [2].…”

Synchronous tumours detected during cancer patient staging: prevalence and patterns of occurrence in multidetector computed tomography

“…Both the primary tumour and associated tumours in adjacent and/or distant organs can be detected [23]. However, despite the interesting perspective that is achieved by high-quality multiplanar reconstruction MDCT imaging and its utility in the correct assessment of tumour extension, CT sensitivity in discovering further tumours is relatively low (85-90%), especially in the case of lesions not distinguishable from benign abnormality (e.g.…”

Transgluteal access for computed tomography-guided percutaneous puncture of prostatic abscesses

“…Once the diagnosis is established, the standard treatment options are the administration of antibiotics, open perineal drainage, and transurethral resection of the prostatic abscess. Currently, however, minimally invasive procedures such as needle aspiration guided by imaging methods are well established in interventional radiology practice and are preferable to conventional methods, with low rates of complications and satisfactory therapeutic results (1)(2)(3)(4)(5)(6)(7)(8) .…”