• Title "The Role of PET-CT in Detecting Metastatic Cancers"
  • Parisa Maleki,1,* Ali Bejani,2
    1. Student Committee of Medical Education Development, Education Development Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
    2. Student Committee of Medical Education Development, Education Development Center, Kurdistan University of Medical Sciences, Sanandaj, Iran


  • Introduction: Accurate staging is crucial when breast cancer is first diagnosed, as it guides treatment and prognosis. Traditional imaging methods often miss distant or small metastases, especially in high-risk patients. ^18F-FDG PET-based imaging, such as PET/CT and PET/MRI, offers improved detection by highlighting metabolic activity. A systematic review and meta-analysis evaluated how often PET imaging alters staging and treatment plans, and which clinical factors predict greater diagnostic benefits.
  • Methods: We searched PubMed, Web of Science, and Google Scholar for studies published over the past ten years. Our search included keywords like "PET-CT in metastatic cancer detection," "Diagnostic performance of PET-CT in cancer," "Use of PET-CT for staging metastatic cancers," and other related words. After collecting a wide range of articles, we reviewed their abstracts to assess their relevance. So we chose the most useful studies and used their results to write our final review.
  • Results: Recent evidence highlights the growing role of PET-based imaging—especially PET/CT and PET/MRI—in identifying and managing metastatic cancers. In breast cancer cases, PET imaging changed disease staging in approximately 25% of patients and influenced treatment decisions in 18%, particularly in advanced stages. This underlines its value in tailoring therapies to individual patients. In abdominal and pelvic cancers, ^68Ga-FAPI PET/CT has shown greater accuracy than traditional ^18F-FDG PET/CT for detecting both primary tumors and recurrences, although further studies are needed to confirm its full potential. For prostate cancer, PET/CT has outperformed whole-body MRI in identifying bone metastases, though MRI remains beneficial due to its non-radiative nature. In ovarian cancer, FDG PET/CT was more effective than MRI and MDCT in detecting peritoneal spread, though MRI proved better at identifying smaller lesions. Collectively, PET/CT demonstrates significant value in metastasis detection and guiding treatment, especially in high-risk patients. Still, ongoing research is necessary to refine these technologies and establish long-term clinical benefits. The integration of advanced tracers like FAPI and multimodal imaging could further enhance diagnostic accuracy and personalized care.
  • Conclusion: PET-based imaging, particularly PET/CT and PET/MRI, has become increasingly important in accurately staging cancer and guiding effective treatment strategies. Compared to conventional scans, PET/CT offers improved detection in complex cancers such as breast, prostate, ovarian, and abdominal tumors. Promising tracers like ^68Ga-FAPI may extend these benefits, but further validation is needed. Hospitals should consider wider use of PET imaging in complex cases, and future research should aim to optimize its use and identify which patients benefit most.
  • Keywords: Metastatic cancer detection, Prostate cancer metastasis, PET/CT, Breast cancer, 68Ga-FAPI PET/CT