18F-FDG PET-CT in evaluation of postoperative colorectal cancer patients with rising CEA level

Abstract

This study shows an overall detection rate of 71% for PET/CT compared with 55% for CT in postoperative CRC patients with increasing CEA. PET/CT changes the management in half of the patients, highlighting the superior role of fluorodeoxyglucose PET/CT scan over CT scan.

18F-FDG PET/CT and Colorectal Cancer: Value of Fourth and Subsequent Posttherapy Follow-up Scans for Patient Management

“…In recent years, 18 F-FDG PET/CT has gained special importance in the evaluation of many human solid tumors. In the follow-up of colorectal cancers, 18 F-FDG PET/CT has been shown to have good diagnostic accuracy, has an impact in patient management, and predicts prognosis (3)(4)(5)(6)(7)(8). Although 18 F-FDG PET/CT has not been recommended in the routine follow-up of colorectal cancer, studies have shown that PET/CT is superior to conventional imaging methods in the follow-up (9)(10)(11).…”

A General Cutoff Level Combined With Personalized Dynamic Change of Serum Carcinoembryonic Antigen Can Suggest Timely Use of FDG PET for Early Detection of Recurrent Colorectal Cancer

“…[17][18][19][20][25][26][27][28][29][30] For patients with metastatic CRC, a preoperative PET scan before hepatic surgery was reported to have benefit in reducing subsequent recurrence by detecting occult metastases and, furthermore, could avoid futile laparotomies in some cases. [31][32][33] Because of the high sensitivity in detecting metastatic CRC, FDG PET has also been used in patients presenting with unexplained serum CEA level elevations.…”

“…Several other studies on the utility of FDG PET for patients with posttherapy CEA level rise seen in follow-up examinations also disclosed the superiority of FDG PET over the conventional imaging studies. [21][22][23][24][25][26][27] Between July 2002 and May 2010, more than 100 patients had FDG PET examinations on account of rising serum CEA levels, which indicated possible recurrent disease. Although we observed the high sensitivity of FDG PET in detecting sites of recurrent CRC in these patients, we also noted the inconsistency in efficacy of the FDG PET between patients with greater CEA level rise and those with milder elevations.…”

Early PET‐CT in patients with pathological stage III colon cancer may improve their outcome: Results from a large retrospective study

“…The use of 18 Fluorodeoxyglucose (FDG) Positron Emission Tomography‐Computed Tomography (PET‐CT) has allowed a more accurate staging and improved the management of various cancers and multiple clinical settings. However, its use in CC is currently limited to evaluation of unclear findings in conventional imaging during preoperative staging or follow‐up, work‐up for rising carcinoembryonic antigen (CEA) levels and preoperative staging of potentially resectable liver metastases . According to current guidelines, the routine use of PET or PET‐CT is clearly not indicated for the diagnosis or staging of clinical stage I‐III CC nor for the routine surveillance of these patients following curative surgery, regardless of their risk for recurrence …”