Sajjad Rostami, Hannah W Stutterheim, Olga Maxouri, Jeroen R J Willemse, Diana Ivonne Rodríguez Sánchez, Winnie Schats, Larissa W van Golen, Marieke A Vollebergh, Zing Cheung, Wouter V Vogel, Serena Marchetti, Petur Snaebjornsson, Max J Lahaye, Doenja M J Lambregts, Zuhir Bodalal, Regina G H Beets-Tan
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引用次数: 0
Abstract
Objectives: To evaluate the evolution and current diagnostic capabilities of medical imaging in cancer of unknown primary (CUP) and explore promising technologies for enhancing diagnostic precision.
Methods: A comprehensive literature search was conducted across MEDLINE, Embase, and Scopus in March 2023 (updated in August 2024) to identify original articles focusing on CUP imaging. Two reviewers independently selected articles and extracted data. Quality assessment was performed using QUADAS-2 and Radiomics Quality Score. Given the variability in study designs, imaging techniques, and reported outcomes, a narrative synthesis was performed. Subgroup analyses compared detection rates across modalities.
Results: From 4760 de-duplicated search results, 140 original articles were included. Early CUP imaging relied on two-dimensional modalities with notable diagnostic limitations. Modern three-dimensional modalities have risen in prominence, though mammography and ultrasound remain in CUP guidelines. Implementing CT and MRI significantly improved primary tumor detection and disease characterization. CT is fundamental for CUP evaluation, and MRI offers superior soft tissue resolution, effective for detecting occult breast cancer, head and neck primaries, and suspected abdominopelvic neoplasms. FDG-PET/CT showed varying primary detection capabilities, adding value in identifying lesions/metastases missed by other modalities, essential for confirming locoregional treatment strategies. Emerging technologies for CUP imaging include whole-body MRI, FAPI-PET/CT, and AI/radiomics.
Conclusions: Advancements in imaging have improved the diagnostic workup for CUP. Innovative approaches show potential for further improvement in diagnostic accuracy.
Advances in knowledge: This study provides a comprehensive overview of CUP imaging and introduces emerging modalities that could boost diagnostic accuracy.
期刊介绍:
BJR is the international research journal of the British Institute of Radiology and is the oldest scientific journal in the field of radiology and related sciences.
Dating back to 1896, BJR’s history is radiology’s history, and the journal has featured some landmark papers such as the first description of Computed Tomography "Computerized transverse axial tomography" by Godfrey Hounsfield in 1973. A valuable historical resource, the complete BJR archive has been digitized from 1896.
Quick Facts:
- 2015 Impact Factor – 1.840
- Receipt to first decision – average of 6 weeks
- Acceptance to online publication – average of 3 weeks
- ISSN: 0007-1285
- eISSN: 1748-880X
Open Access option