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The value of F-18 fluorodeoxyglucose positron emission tomography/computed tomography in asymptomatic examinees with unexplained elevated blood carcinoembryonic antigen levels

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Cancer is still a clinical challenge, with many efforts invested in order to achieve timely detection. Unexplained elevated blood carcinoembryonic antigen levels are occasionally observed in an asymptomatic population and considered as a risk factor of cancers. The purpose of this study was to determine the validity of 18 F-fluorodeoxyglucose-positron emission tomography/computed tomography (F-18 FDG-PET/CT) for detecting cancer in an asymptomatic population with an unexplained elevation in blood carcinoembryonic antigen (CEA) levels.

Methods

This retrospective study included a total of 1920 asymptomatic examinees conducted from August 2011 through September 2013. The participants underwent CEA assay and conventional medical imaging (CEA-conventional), or CEA assay and F-18 FDG-PET/CT (CEA-PET/CT). The validity of conventional medical imaging and CEA-PET/CT scanning for detecting cancer and early-stage cancer in an asymptomatic population with an unexplained elevation in blood CEA levels were evaluated.

Results

Sensitivity, specificity, cancer detection rate, missed cancer detection rate, early-stage cancer detection rate, and early-stage cancer ratio using the CEA-PET/CT scanning were 96.6 %, 100 %, 10.4 %, 0.4 %, 3.7 %, and 34.5 %, respectively. In contrast, the corresponding values obtained using the conventional medical imaging were 50.6 % (P < 0.0001), 100 % (P > 0.9999), 50.6 % (P < 0.0001), 99.9 % (P = 0.055), 2.6 % (P < 0.0001), 2.5 % (P = 0.04), 0.7 % (P = 0.0004), and 14.5 % (P = 0.002), respectively.

Conclusion

The F-18 FDG-PET/CT scanning significantly improved the validity of the cancer detection program in the asymptomatic population with an unexplained elevation in CEA levels.

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Acknowledgments

We thank professor Xincheng Lu (Institute of Genomic Medicine, Wenzhou Medical University, Wenzhou, China), Caicun Zhou (Department of Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China), Yi Lu (Department of Radiotherapy, Lihuili Hospital, Ningbo Medical Center, Ningbo, China), Xiaozhong Chen (Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, China), Weijia Fang (Department of Medical Oncology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China), Zhengyang Xu (Department of Chemo-radiotherapy, People’s Hospital of Yinzhou district, Ningbo, China) and Yuefen Zhou (Department of Oncology, Lishui City Central Hospital, Lishui, China) for helping in data collection. This work was funded in part by the Natural Science Foundation of China (grant no. 81373075, 81371748) and the Science Technology Department of Zhejiang Province of China (grant no.2013C33171).

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    Authors and Affiliations

    1. Laboratory for Advanced Interdisciplinary Research, Institutes of Translational Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

      Wenfeng Li, Rongying Ou, Ting Chen, Lingling Xiong, Dezhi Cheng, Deyao Xie, Xiangwu Zheng, Yunsheng Xu & Liang Zhao

    2. Department of Radiation Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

      Wenfeng Li

    3. Division of PET/CT, Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

      Weiwei Yin, Xiangwu Zheng & Liang Zhao

    4. Department of Gynaecology and Obstetrics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

      Rongying Ou

    5. Department of Dermatovenereology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

      Ting Chen, Lingling Xiong & Yunsheng Xu

    6. Department of Cardiothoracic Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

      Dezhi Cheng & Deyao Xie

    7. Institutes of Intelligent and Molecular Imaging, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

      Xiangwu Zheng & Liang Zhao

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    1. Wenfeng Li
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    Correspondence to Yunsheng Xu or Liang Zhao.

    Ethics declarations

    The study was approved by the ethics committee of the First Affiliated Hospital of Wenzhou Medical University, and all examinees provided a written informed consent.

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    The authors declare that they have no conflicts of interest.

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    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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    Wenfeng Li, Weiwei Yin and Rongying Ou contributed equally to this work.

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    Li, W., Yin, W., Ou, R. et al. The value of F-18 fluorodeoxyglucose positron emission tomography/computed tomography in asymptomatic examinees with unexplained elevated blood carcinoembryonic antigen levels. Eur J Nucl Med Mol Imaging 43, 675–681 (2016). https://doi.org/10.1007/s00259-015-3233-0

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