The relationship and optimal cutoff value between dual-phase corrected whole-body uptake ratio (CUR) and serum CEA level in recurrent/metastatic colorectal carcinoma: Dual-phase whole body protocol using time-of-flight (TOF) imaging

초록

Objectives We evaluate whether the corrected SUR has a lineal relationship with a serum CEA level, and to determine the cutoff level of SUV and CEA level in metastatic focus of recurrent colorectal carcinoma. Tumor to background contrast in whole-body PET/CT at 1 hour and 2 hour The relationship and optimal cutoff value between %change max SUV and serum CEA level in metastatic colorectal carcinoma: ROC analysis. Methods 48 patients (M: F=32:16, mean age 56.1+/-11) who were previously operated for primary colorectal carcinoma enrolled for evaluating metastasis / recurrence from April 2007 to Feb 2008. An one hour and two hour whole body PET/CT (brain to foot) (Gemini TF PET/CT, Philips Medical Systems) was performed after injection of 370-555 MBq of F-18 FDG. The serum CEA level (CEA) measured. The time interval between the PET/CT and the CEA 6.8 +/- 3.1 days. Background (BG) correct uptake ratio (CUR)[CUR/BG]= maximum SUV of the ROI/ background value (mean SUV of the liver) calculated and then % change of the CUR at 1 hour and CUR at 2 hour were calculated. Results Among the 48 patients, recurrence was confirmed in 41patients, and the remaining 9 patients were disease-free. A significant lineal correlation between % change of the CUR at 1 hour and CUR at 2 hour and CEA was founded using ROC analysis (P<0.05). The optimal cutoff value of the % change of the CUR at 1 hour and CUR at 2 hour and CEA were 71 % (sensitivity86.7, specificity 83.3, AUC 0.878 0.047) and 9.44ng/ml (sensitivity 73.3, specificity 87.5, AUC 0.857+/-0.051) respectively. The difference of AUC between the % change of the CUR at 1 hour and CUR at 2 hour and CEA was not significantly different (0.022+/-0.065 , P = 0.739). Conclusions The % change of CUR at 1 hour and 2 hour calculated from the dual-phase corrected whole-body uptake ratio in metastatic focus was shown a lineal correlation with serum CEA level in patients with recurrent colorectal carcinoma. The % change of CUR of 70 % and the CEA level of 9.44 ng/ml was best cutoff value in detecting the recurrent/metastatic focus in colorectal carcinoma.