Nucl Med Mol Imaging.  2009 Apr;43(2):120-128.

Diagnostic Role of F-18 FDG PET/CT in the Follow-up of Patients with Colorectal Cancer: Comparison with Serum CEA, CA 19-9 Levels and Computed Tomography

• Kang S
• Song BI
• Lee HJ
• Seo JH
• Lee SW
• Yoo J
• Ahn BC
• Lee J
• Choi K
• Jun SH

Abstract

PURPOSE: Early detection of recurrence is an important factor for long term survival of patients with colorectal cancer. Measurement of serum levels of CEA, CA 19-9, CT and PET/CT has been commonly used in the postoperative surveillance of colorectal cancer. The purpose of this study was to compare the diagnostic ability of PET/CT, tumor marker and CT for recurrence in colorectal cancer patients after treatment.
MATERIALS AND METHODS
F-18 FDG PET/CT imaging was performed in 189 colorectal cancer patients who underwent curative surgical resection and/or chemotherapy. Measurement of serum levels of CEA, CA 19-9 and CT imaging were performed within 2 months of PET/CT examination. Final diagnosis of recurrence was made by biopsy, radiologic studies or clinical follow-up for 6 months after each study.
RESULTS
Overall sensitivity, specificity of PET/CT was 94.7%, 91.1%, while those of serum CEA were 44.7% and 97.3%, respectively. Sensitivity and specificity were 94.2%, 90.4% for PET/CT and better than those of combined CEA and CA 19-9 measurement (52.1%, 88.5%) in 174 patients measured available both CEA and CA 19-9 data. In 115 patients with both tumor markers and CT images available, PET/CT showed similar sensitivity but higher specificity (92.9%, 91.3%) compared to combination of tumor markers and CT images (92.9%, 74.1%).
CONCLUSION
PET/CT was superior for detection of recurred colorectal cancer patients compared with both CEA, CA 19-9, and even with combination of both tumor markers and CT. Therefore PET/CT could be used as a routine surveillance examination to detect recurrence or metastasis of colorectal cancer.

Keyword

Colorectal cancer; F-18 FDG PET/CT; carcinoembryonic antigen; carbohydrate antigen 19-9; computed tomography; recurrence

MeSH Terms

Biopsy
Carcinoembryonic Antigen
Colorectal Neoplasms
Follow-Up Studies
Humans
Neoplasm Metastasis
Recurrence
Sensitivity and Specificity
Biomarkers, Tumor
Carcinoembryonic Antigen