detection of prostate cancer by an fdg-pet cancer screening program: results from a japanese nationwide survey

objective(s): the aim of this study was to analyze detection rates and effectiveness of 18f-fluorodeoxyglucose positron emission tomography (fdg-pet) cancer screening program for prostate cancer in japan, which is defined as a cancer-screening program for subjects without known cancer. it contains fdg-pet aimed at detection of cancer at an early stage with or without additional screening tests such as prostate-specific antigen (psa) and magnetic resonance imaging (mri). methods: a total of 92,255 asymptomatic men underwent the fdg-pet cancer screening program. of these, 504 cases with findings of possible prostate cancer in any screening method were analyzed. results: of the 504 cases, 165 were verified as having prostate cancer. of these, only 61 cases were detected by fdg-pet, which result in 37.0% relative sensitivity and 32.8% positive predictive value (ppv). the sensitivity of pet/computed tomography (ct) scanner was higher than that of dedicated pet (44.0% vs. 20.4%). however, the sensitivity of fdgpet was lower than that of psa and pelvic mri. fdg-pet did not contribute to improving the sensitivity and ppv when performed as combined screening. conclusion: psa should be included in fdg-pet cancer screening programs to screen for prostate cancer.