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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, Sung-Min (Department of Nuclear Medicine, Kyungpook National University Hospital)
Song, Bong-Il (Department of Nuclear Medicine, Kyungpook National University Hospital)
Lee, Hong-Je (Department of Nuclear Medicine, Kyungpook National University Hospital)
Seo, Ji-Hyoung (Department of Nuclear Medicine, Kyungpook National University Hospital)
Lee, Sang-Woo (Department of Nuclear Medicine, Kyungpook National University Hospital)
Yoo, Jeong-Soo (Department of Nuclear Medicine, Kyungpook National University Hospital)
Ahn, Byeong-Cheol (Department of Nuclear Medicine, Kyungpook National University Hospital)
Lee, Jae-Tae (Department of Nuclear Medicine, Kyungpook National University Hospital)
Choi, Kyu-Suk (Department of Surgery, Kyungpook National University Hospital)
Jun, Soo-Han (Department of Surgery, Kyungpook National University Hospital)
Publication Information
Nuclear Medicine and Molecular Imaging / v.43, no.2, 2009 , pp. 120-128 More about this Journal
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.
Keywords
Colorectal cancer; F-18 FDG PET/CT; carcinoembryonic antigen; carbohydrate antigen 19-9; computed tomography; recurrence;
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