Value of 18F-FDG PET-CT in surveillance of postoperative colorectal cancer patients with various carcinoembryonic antigen concentrations

• Published in: World journal of gastroenterology : WJG Vol. 20; no. 21; pp. 6608 - 6614
• Main Authors: Zhang, Yan, Feng, Bin, Zhang, Guo-Li, Hu, Man, Fu, Zheng, Zhao, Fen, Zhang, Xiao-Li, Kong, Li, Yu, Jin-Ming
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 07-06-2014
• Subjects: Adult; Aged; antigen; cancer; Carcinoembryonic; Carcinoembryonic Antigen - metabolism; Colorectal; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - metabolism; Female; Fluorod; Fluorodeoxyglucose F18; Humans; Male; Middle Aged; Multimodal Imaging; Neoplasm Metastasis; Neoplasm Recurrence, Local; Positron-Emission Tomography; Postoperative Period; Radiopharmaceuticals; Retrospective Studies; Retrospective Study; Sensitivity and Specificity; Tomography, X-Ray Computed; Carcinoembryonic antigen; Recurrence; Metastasis; Fluorodeoxyglucose positron emission tomography/computed tomography; Colorectal cancer
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v20.i21.6608

AIM:To evaluate the value of positron emission tomography(PET)/computerized tomography(CT)in surveillance of colorectal cancer(CRC)patients with different carcinoembryonic antigen(CEA)concentrations.METHODS:One hundred and six postoperative CRC patients who had suspected recurrence or metastasis and received fluorodeoxyglucose(FDG)PET/CT within one week were included in this study.The final diagnosis was confirmed by histological examination or clinicalfollow-up over at least six months.RESULTS:The sensitivity,specificity,and accuracy of FDG PET/CT were 95.2%,82.6%,and 92.5%,and94.8%,81.4%and 92.8%,respectively,in the caseand lesion-based analyses.The sensitivity and accuracy of FDG PET/CT significantly differed from CT in both analyses(χ2=8.186,P=0.004;χ2=6.201,P=0.013;χ2=13.445,P=0.000;χ2=11.194,P=0.001).In the lesion-based analysis,the sensitivity,specificity,and accuracy of FDG PET/CT in the abnormal CEA group were97.8%,82.6%,and 95.6%,compared with 81.3%,80%,and 80.6%for patients with normal CEA levels.In case-based analysis,the sensitivity,specificity,and accuracy of FDG PET/CT were 97.2%,77.8%,and 95%in abnormal CEA group.Only in lesion-based analysis,the sensitivity and accuracy of FDG PET/CT in the abnormal CEA group were significantly superior to those in the normal CEA group(χ2=6.432,P=0.011;χ2=7.837,P=0.005).FDG PET/CT changed the management in 45.8%of patients with positive scans.CONCLUSION:FDG PET/CT showed superior diagnostic value and is an advisable option in surveillance of postoperative CRC patients with a vague diagnosis.