18F-FDG PET/CT superior to serum CEA in detection of colorectal cancer and its recurrence

Published:September 03, 2013DOI:


      The aim of this study was to examine whether positron emission tomography (PET)/computed tomography (CT) can detect more cases of colorectal cancer (CRC) than serum carcinoembryonic antigen (CEA), both at initial staging and during surveillance for recurrence. A retrospective review of 639 CRC patients imaged with PET/CT was performed. PET/CT was superior to serum CEA in detecting CRC, identifying 2.5 times as many CRC at initial staging compared to serum CEA and 1.5 times as many CRC recurrences. The current guideline recommendations of utilizing PET/CT only in the context of a rising serum CEA will miss more than one third of all CRC recurrences.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Clinical Imaging
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Gold P
        • Freeman SO
        Demonstration of tumor-specific antigens in human colonic carcinomata by immunological tolerance and absorption techniques.
        J Exp Med. 1965; 121: 439-462
        • Wang JY
        Prognostic significance of pre- and postoperative serum carcinoembryonic antigen levels in patients with colorectal cancer.
        Eur Surg Res. 2007; 39: 245-250
        • Desch CE
        • Benson AB
        • Somerfield MR
        Colorectal cancer surveillance: 2005 update of an American Society of Clinical Oncology practice guideline.
        J Clin Oncol. 2005; 23: 8512-8519
        • Abdel-Nabi H
        • Doerr RJ
        • Lamonica DM
        • Cronin VR
        • Galantowicz PJ
        • Carbone GM
        • et al.
        Staging of primary colorectal carcinomas with fluorine-18 fluorodeoxy-glucose whole body PET: correlation with histopathologic and CT findings.
        Radiology. 1998; 206: 755-760
        • Chen LB
        • Tong JL
        • Song HZ
        • Zhu H
        • Wang YC
        18F-FDG PET/CT in detection of recurrence and metastasis of colorectal cancer.
        World J Gastroenterol. 2007; 13: 5025-5029
        • Cohade C
        • Osman M
        • Leal J
        • Wahl R
        Direct comparison of (18)F-FDG PET and PET/CT in patients with colorectal carcinoma.
        J Nucl Med. 2003; 44: 1797-1803
        • Moertel CG
        • Fleming TR
        • McDonald JS
        • Haller DG
        • Laurie JA
        • Tangen C
        An evaluation of the carcinoembryonic antigen (CEA) test for monitoring patients with resected colon cancer.
        JAMA. 1993; 270: 943-947
        • Ito K
        • Hibi K
        • Ando H
        • Hidemura K
        • Yamazaki T
        • Akiyama S
        • et al.
        Usefulness of analytical CEA doubling time and half-life time for overlooked synchronous metastases in colorectal carcinoma.
        Jpn J Clin Oncol. 2002; 32: 54-58
        • Gambhir SS
        • Czernin J
        • Schwimmer J
        • Silverman DHS
        • Coleman RE
        • Phelps ME
        A tabulated summary of the FDG PET literature.
        J Nucl Med. 2001; 42 (Suppl.): 1S-93S
        • Votrubova J
        • Belohlavek O
        • Jaruskova M
        • Oliverius M
        • Lohynska R
        • Trskova K
        • et al.
        The role of FDG-PET/CT in the detection of recurrent colorectal cancer.
        Eur J Nucl Med Mol Imaging. 2006; 33: 779-784
        • Kang S
        • Seo JH
        • Bae JH
        • Lee SW
        • Yoo J
        • Ahn BC
        • et al.
        F-18 FDG PET/CT can detect recurrence earlier than serum CEA level in patients with colorectal cancer after curative surgical resection.
        J Nucl Med. 2007; 48: 389P