Abstract
F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) plays an important role in less invasive and individualized cancer therapy, which is a recent trend in clinical oncology. There are four main roles in FDG PET for cancer patients as follows: (1) differential diagnosis of already-known lesions, (2) staging of malignant tumors, (3) evaluation of therapeutic effects of non-surgical treatment, and (4) surveillance of recurrent tumors. These kinds of usefulness of FDG PET is described in Japanese clinical guidelines for various types of malignancy. Nationwide survey of FDG PET is performed every 5 years in Japan and the results of this series of surveys revealed a recent dramatic increase in the number of FDG PET. This dramatic increase in Japan is induced by wide coverage of FDG PET by public health insurance and commercial distribution of FDG. However, there is a problem in the coverage of FDG PET by public health insurance in Japan. FDG PET for evaluation of therapeutic effects is covered by insurance only for malignant lymphoma. There is a unique application of FDG PET in Japan. Many PET imaging centers include FDG PET in their cancer screening programs and they often reported high detection ratio of malignancy more than 1%. FDG PET is now an essential tool in the field of oncology in Japan as in most of developed countries.
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