Document Detail


Ability of 18F-FDG PET/CT to diagnose recurrent colorectal cancer in patients with elevated CEA concentrations.
MedLine Citation:
PMID:  20364373     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Elevated levels of serum carcinoembryonic antigen (CEA) in patients with colorectal cancer (CRC) during follow-up suggest recurrence, which can be visualized by (18)F-FDG PET/CT. Since the magnitude of CEA elevation reflects cancer volume, the ability of PET/CT to detect recurrence in patients with only mildly elevated CEA might be limited. However, the accuracy of PET/CT in detecting recurrence associated with elevated CEA has not been fully assessed. We retrospectively evaluated the diagnostic performance of (18)F-FDG PET/CT postoperatively relative to CEA levels among patients with CRC. METHODS: We visually assessed 75 PET/CT evaluations of 57 postoperative patients with CEA >5.0 ng/ml. Tumor volumes were also determined using image analysis software. The final diagnosis was confirmed based on histopathological findings, or at least on 6 months of clinical follow-up. RESULTS: Two lung cancers were excluded and we finally analyzed data from 73 of the 75 PET/CT evaluations. Recurrences were diagnosed in 54 (prevalence 74%). The sensitivity and specificity of PET/CT to detect recurrence was 50/54 (93%) and 14/19 (74%), respectively. The positive and negative predictive values were 91 and 78%, respectively, and the positive and negative likelihood ratios were 3.52 and 0.10, respectively. Values for the sensitivity of PET/CT were 88 and 95%, and those for specificity were 78 and 70%, at serum CEA concentrations of 5-10 and >10 ng/ml, respectively. Serum CEA (r = 0.500, p < 0.001) significantly correlated with cancer volumes. CONCLUSIONS: The present findings showed that (18)F-FDG PET/CT could accurately detect recurrent CRC irrespective of the elevated CEA concentration.
Authors:
Yukishige Kyoto; Mitsuru Momose; Chisato Kondo; Michio Itabashi; Shingo Kameoka; Kiyoko Kusakabe
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Publication Detail:
Type:  Journal Article     Date:  2010-04-03
Journal Detail:
Title:  Annals of nuclear medicine     Volume:  24     ISSN:  1864-6433     ISO Abbreviation:  Ann Nucl Med     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-15     Completed Date:  2010-09-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8913398     Medline TA:  Ann Nucl Med     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  395-401     Citation Subset:  IM    
Affiliation:
Department of Radiology, Japan Self-Defense Forces Central Hospital, Tokyo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Carcinoembryonic Antigen / blood*
Colorectal Neoplasms / blood*,  diagnosis*,  pathology,  surgery
False Negative Reactions
False Positive Reactions
Female
Fluorodeoxyglucose F18 / diagnostic use*
Humans
Male
Middle Aged
Positron-Emission Tomography*
Recurrence
Retrospective Studies
Tomography, X-Ray Computed*
Tumor Burden
Chemical
Reg. No./Substance:
0/Carcinoembryonic Antigen; 63503-12-8/Fluorodeoxyglucose F18

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