Utility of 2-Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography in Managing Patients of Colorectal Cancer With Unexplained Carcinoembryonic Antigen Elevation at Different Levels

Liu, Feng-Yuan; Chen, Jinn‐Shiun; Changchien, Chi‐Sin; Yeh, Chien-Yuh; Liu, Shu-Hsing; Ho, Keang-Po; Yen, Tzu‐Chen

doi:10.1007/s10350-005-0097-6

Cited by 31 publications

(18 citation statements)

References 33 publications

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“…Elevated serum CEA levels are detected in two-thirds of patients with recurrence of colorectal carcinoma and have been associated with a 3–9-month median lead-time in detection of recurrence over anatomic imaging modalities [5, 35–39]. Measurement of serum CEA every 2–3 months for at least 2 years after surgery has been advocated [35, 40–42]. Such intensive follow-up after primary curative treatment may detect more cancer relapses that are amenable to curative resection.…”

Section: Detection Of Recurrent Diseasementioning

confidence: 99%

“…Patients with rising serum CEA levels without detectable disease on morphological imaging pose a clinical challenge. Abnormal serum CEA levels are also observed in a variety of benign conditions, such as liver diseases, bowel diseases, smoking, and renal failure [35]. The problem with false-positive serum CEA elevation is that it may lead to unnecessary imaging or even surgery with associated morbidity.…”

Section: Detection Of Recurrent Diseasementioning

confidence: 99%

“…Fletcher concluded that a serum CEA >10 ng /ml was rarely caused by benign conditions [54]. Liu et al [35] reported that the cumulative survival of patients with an unexplained serum CEA level >25 ng /ml was significantly worse than that of patients with levels <25 ng /ml. They suggested a serum CEA cutoff value of 10 ng /ml as an indication for FDG-PET.…”

Section: Detection Of Recurrent Diseasementioning

confidence: 99%

“…Its sensitivity is approximately 80%, but is not as high for locoregional recurrence and pulmonary metastases as it is for liver metastases [5]. In asymptomatic patients with rising serum CEA levels without abnormal findings of conventional workup, the sensitivity for detection of recurrence with FDG-PET has been reported as 79–100%, specificity as 50–83%, and accuracy as 74–93% [22, 35, 45–49]. Positive predictive values ranged from 89% to 95% and negative predictive values from 85% to 100% [22, 45, 47].…”

Section: Detection Of Recurrent Diseasementioning

confidence: 99%

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FDG-PET in colorectal cancer

Geus‐Oei¹

2006

Cancer Imaging

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Abstract[ 18 F]Fluorodeoxyglucose (FDG) positron emission tomography (PET) is a useful imaging tool in the evolving management of patients with colorectal carcinoma. This technique is able to measure and visualize metabolic changes in cancer cells. This feature results in the ability to distinguish viable tumor from scar tissue, in the detection of tumor foci at an earlier stage than possible by conventional anatomic imaging and in the measurement of alterations in tumor metabolism, indicative of tumor response to therapy. Nowadays, FDG-PET plays a pivotal role in staging patients before surgical resection of recurrence and metastases, in the localization of recurrence in patients with an unexplained rise in serum carcinoembryonic antigen and in assessment of residual masses after treatment. In the presurgical evaluation, FDG-PET may be best used in conjunction with anatomic imaging in order to combine the benefits of both anatomical (CT) and functional (PET) information, which leads to significant improvements in preoperative liver staging and preoperative judgment on the feasibility of resection. Integration of FDG-PET into the management algorithm of these categories of patients alters and improves therapeutic management, reduces morbidity due to futile surgery, leads to substantial cost savings and probably also to a better patient outcome. FDG-PET also appears to have great potential in monitoring the success of local ablative therapies soon after intervention and in the prediction and evaluation of response to radiotherapy, systemic therapy, and combinations thereof. This review aims to outline the current and future role of FDG-PET in the field of colorectal cancer.

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Section: Detection Of Recurrent Diseasementioning

confidence: 99%

Section: Detection Of Recurrent Diseasementioning

confidence: 99%

Section: Detection Of Recurrent Diseasementioning

confidence: 99%

Section: Detection Of Recurrent Diseasementioning

confidence: 99%

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FDG-PET in colorectal cancer

Geus‐Oei¹

2006

Cancer Imaging

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“…An interesting subset of such studies has examined patients whose only abnormality was elevated CEA, i.e., conventional imaging was normal in hepatic and extrahepatic sites. Five of such studies were identified [19][20][21][22][23] (Table 2). FDG-PET was highly effective in locating the cancer in most of these patients, both in hepatic and extrahepatic sites.…”

Section: Detection Of Extrahepatic Metastatic Deposits Of Colorectal mentioning

confidence: 99%

Detection and Management of Extrahepatic Colorectal Cancer in Patients with Resectable Liver Metastases

Yang¹,

Fleshman

Strasberg

2007

Journal of Gastrointestinal Surgery

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The presence of extrahepatic disease has a great effect on the management of patients with metastatic colorectal cancer in the liver. FDG-PET scanning is currently the most sensitive way of detecting extrahepatic metastases in such patients. This is supported by 10 studies, which show that FDG-PET scan will discover extrahepatic disease in about one in six patients who have completed standard imaging. Staging laparoscopy is another means of detecting extrahepatic disease. Its role remains undefined especially in patients who have had FDG-PET scans. It should probably be restricted to patients with high clinical risk scores. In terms of treatment, patients with recurrence at the primary colorectal site as well as resectable liver metastases appear to benefit from resection of both sites provided that R0 resections can be obtained. Resection of involved hepatic pedicle lymph nodes in patients with resectable liver metastases is associated with poor outcome. The situation regarding patients with peritoneal and liver metastases bears a strong resemblance to that of primary site recurrence and liver metastases. Very acceptable survival can be expected if the peritoneal disease can be eradicated. Information regarding treatment of lung and liver metastases is the most complete of any of these areas. Good results may be expected if all the disease can be cleared. Caution is required in interpreting claims of good survival when study numbers are small and confidence intervals of data are not provided.

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Positron Emission Tomography of the Liver

Sørensen¹,

Keiding

2007

Textbook of Hepatology

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Utility of 2-Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography in Managing Patients of Colorectal Cancer With Unexplained Carcinoembryonic Antigen Elevation at Different Levels

Cited by 31 publications

References 33 publications

FDG-PET in colorectal cancer

FDG-PET in colorectal cancer

Detection and Management of Extrahepatic Colorectal Cancer in Patients with Resectable Liver Metastases

Positron Emission Tomography of the Liver

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