Abstract:
When confronted with a suspicious rise in CA
15.3 in asymptomatic breast cancer patients following
primary treatment and negative or equivocal conventional
imaging findings, FDG PET/CT allows assessment of the
site and extent of the recurring disease with an accuracy
of 83 %. Both FDG PET and FDG PET/CT are superior
when compared to CT alone for the purpose of recurrence
detection in patients suffering from ovarian carcinoma
who have completed primary therapy but demonstrate a
rising serum CA-125 level. As the global accuracy of CT
alone for detection of recurrence of ovarian cancer
approximates 80 %, CT scan should be performed upfront
to identify the site of recurrence. When confronted with
negative or equivocal CT findings, FDG PET alone or
FDG PET/CT should be added. In patients with rising serum CEA levels that have undergone primary treatment
for a colorectal carcinoma, both FDG PET and FDG PET/
CT allow detection of tumor recurrence with an accuracy
of 95 %, well above that of CT and MRI. Available
studies further suggest that FDG/PET findings will affect
treatment management in 28–50 % of these patients. The
detection rate of both 11C-choline and 18F-choline PET
and PET/CT for local, regional, and distant recurrence in
prostate carcinoma patients with a biochemical recurrence
increases with rising PSA value at the time of imaging
and reaches about 75 % in patients with PSA[3 ng/mL.
Furthermore, PET and PET/CT with [11C]- and [18F]-
choline derivates may be helpful in the clinical setting for
optimization of individualized treatment.
