Article Figures & Data
Figures
- FIGURE 1.
An 81-y-old man with cancer of sigmoid colon, after surgery, increasing carcinoembryonic antigen (CEA) serum levels, and a repeated negative CT study. (A) PET shows focal area of increased 18F-FDG uptake in right upper abdomen. (B) Hybrid PET/CT images precisely localized this uptake to colon, consistent with physiologic bowel excretion. Malignancy was excluded and study was reported as normal. Patient had no evidence of recurrence in colon during 15 mo of clinical follow-up.
- FIGURE 2.
A 52-y-old man with colon cancer, after surgery, increasing carcinoembryonic antigen (CEA) serum levels, and a repeated negative CT study. (A) PET shows focal area of abnormal 18F-FDG uptake in left upper abdomen, suggestive of recurrence. (B) Hybrid PET/CT images precisely localized this uptake anterior to tail of pancreas, medial to spleen. Retrospective evaluation of CT performed 2 mo earlier and examination of CT study performed simultaneously with PET did not reveal any abnormalities. Surgeons used location provided by PET/CT for reexploration of abdomen and recurrent tumor in colon was found.
Tables
- TABLE 1
Clinical Characteristics of 36 Cancer Patients with Increasing Concentrations of Tumor Markers and Negative CT
Characteristic Value Sex (no. of patients) Male 17 Female 19 Age (y) Mean 61 Range 32–84 Histology of primary tumor (no. of patients) Colorectal 21 Breast 7 Lung 4 Pancreas 1 Prostate 1 Ovary 1 Thyroid 1 Time from last treatment (mo) Mean 27.6 Range 2–184 Rising levels of tumor markers (no. of patients) CEA 25 CA 15-3 5 CA 19-9 4 CA-125 3 MCA 2 PSA 1 Thyroglobulin 1 CEA = carcinoembryonic antigen; CA = carbohydrate antigen; MCA = mucin-like carcinoma-associated antigen; PSA = prostate-specific antigen.
- TABLE 2
Comparative Analysis of PET and PET/CT Site-Based Performance in 111 Suggestive Lesions in 36 Patients with Suspected Occult Cancer Recurrence Due to Rising Levels of Tumor Markers
Performance PET PET/CT TP (n) 80 83 TN (n) 14 25 FP (n) 14 3 FN (n) 3 — Sensitivity (%) 96 100 Specificity* (%) 50 89 Accuracy* (%) 85 97 PPV (%) 85 97 NPV (%) 82 100 ↵* P statistically significant for specificity (P < 0.05) and accuracy (P < 0.001).
- TABLE 3
Comparative Analysis of PET and PET/CT Patient-Based Performance in 36 Patients with Suspected Occult Cancer Recurrence Due to Rising Levels of Tumor Markers
Performance PET PET/CT TP (n) 28 28 TN (n) 3 4 FP (n) 3 2 FN (n) 2 2 Sensitivity* (%) 93 93 Specificity* (%) 50 67 Accuracy* (%) 86 89 ↵* P not statistically significant.
Referral Based on PET Based only on incremental contribution of PET/CT Total based on PET/CT results For surgery 1 8 9 For chemotherapy 13 2 15 For radiotherapy 2 2 4 Total 16 12 28 Differences between therapeutic strategy based on PET and PET/CT results were statistically significant (P < 0.01).
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