Unexplained rising carcinoembryonic antigen (CEA) in the postoperative surveillance of colorectal cancer: The utility of positron emission tomography (PET)

P. Flamen*, O. S. Hoekstra, F. Homans, E. Van Cutsem, A. Maes, S. Stroobants, M. Peeters, F. Penninckx, L. Filez, R. P. Bleichrodt, L. Mortelmans

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


The aim of the study was to evaluate the use of positron emission tomography with [18F]-fluorodeoxyglucose (FDG-PET) in patients with unexplained rising carcinoembryonic antigen (CEA) in the postoperative surveillance of colorectal cancer. 50 consecutive patients with elevated CEA levels and a completely normal (n = 31) or equivocal (n = 19) conventional diagnostic work-up (CDW) were retrospectively selected. All PET images were reviewed with full knowledge of the CDW. The gold standard consisted of histology, or clinical follow-up of more than 1 year. Recurrent disease was established in 56 lesions in 43 patients. On a patient-based analysis, the sensitivity of FDG-PET was 34/43 (79%), and the positive predictive value 34/38 (89%). In 14/50 patients (28%), the FDG-PET findings led to a surgical resection with curative intent. On a lesion-based analysis, FDG-PET detected 42/56 lesions (sensitivity: 75%), the positive predictive value was 79% (42/53). These results demonstrate that FDG-PET can have a clear impact on patient management in patients with an unexplained elevation in CEA levels.

Original languageEnglish
Pages (from-to)862-869
Number of pages8
JournalEuropean Journal of Cancer
Issue number7
Publication statusPublished - 2001

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