Imaging of Cancer of Unknown Primary: a systematic literature review of the past, present, and future.

IF 1.8 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
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.

原发不明的癌症影像学:对过去、现在和未来的系统文献综述。
目的:评价未知原发癌(CUP)医学影像学的发展和诊断能力,探讨提高诊断精度的新技术。方法:于2023年3月(更新于2024年8月)在MEDLINE、Embase和Scopus上进行了全面的文献检索,以确定关注CUP成像的原创文章。两位审稿人独立选择文章并提取数据。使用QUADAS-2和放射组学质量评分进行质量评估。考虑到研究设计、成像技术和报告结果的可变性,我们进行了叙事综合。亚组分析比较了不同模式的检出率。结果:4760个去重复搜索结果中,包含140篇原创文章。早期CUP成像依赖于二维模式,具有明显的诊断局限性。尽管乳房x光检查和超声检查仍在CUP指南中,但现代三维模式的重要性已经上升。采用CT和MRI可显著改善原发肿瘤的检测和疾病表征。CT是评估CUP的基础,而MRI提供了优越的软组织分辨率,对发现隐匿性乳腺癌、头颈部原发性乳腺癌和疑似盆腔肿瘤有效。FDG-PET/CT显示出不同的初级检测能力,增加了识别其他方式遗漏的病变/转移的价值,对于确定局部区域治疗策略至关重要。CUP成像的新兴技术包括全身MRI、FAPI-PET/CT和AI/放射组学。结论:影像学的进步改善了CUP的诊断。创新的方法显示出进一步提高诊断准确性的潜力。知识进展:本研究提供了CUP成像的全面概述,并介绍了可以提高诊断准确性的新兴模式。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
British Journal of Radiology
British Journal of Radiology 医学-核医学
CiteScore
5.30
自引率
3.80%
发文量
330
审稿时长
2-4 weeks
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
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