Accuracy of Multi-Detector Computed Tomography, Fluorodeoxyglucose Positron Emission Tomography-CT, and CA 19-9 Levels in Detecting Recurrent Pancreatic Adenocarcinoma

Alireza Hamidian Jahromi, Quyen Chu, Runhua Shi, Hosein Shokouh-Amiri, Guillermo Sangster, Gazi Zibari, Brett Martin, Amol Takalkar

Visit for more related articles at

Abstract

Context We compared the accuracy of fluorodeoxyglucose positron emission tomography-CT (FDG-PET-CT), multi-detectorcomputed tomography (MDCT) and CA 19-9 levels in detecting pancreatic cancer recurrence in patients with resected CA 19-9 positive pancreatic adenocarcinomas. Methods We retrospectively evaluated 122 patients with pancreaticadenocarcinomas who underwent surgical resection of the tumor between January 2002 and December 2011. Twenty-fivepatients had MDCT, FDG-PET-CT and CA 19-9 levels performed no less than six weeks post-operation and within 8 weeks of each other for detection of tumor recurrence. Of these, 20 patients had high pre-operative CA 19-9 levels that dropped to a normal level postoperatively which will be the focus of this study. The sensitivity, specificity, positive and negative predictive value (PPV, NPV), and accuracy of MDCT, FDG-PET-CT, and CA 19-9 in detecting recurrence were compared. Results Operations performed included pyloric sparing pancreaticoduodenectomy (n=9), pancreaticoduodenectomy (n=7), distal pancreatectomy (n=3) and total pancreatectomy (n=1). Three patients had no recurrence, but local recurrence and distant metastasis were seen in 8 (40%) and 12 (60%) patients, respectively. In our study, sensitivity, specificity, PPV, NPV and diagnostic effectiveness (accuracy) were: 82%, 100%, 100%, 50%, 85% for MDCT; 82%, 100%, 100%, 50%, 85% for FDGPET- CT and 94%, 100%, 100%, 75%, 95% for CA 19-9. The difference in recurrence detection accuracy of the tests was not statistically significant. A combination of CA 19-9 with MDCT or FDG-PET-CT was 100% accurate in detecting cancer recurrence in our patients. Conclusion Our data suggests that CA 19-9 levels can be used reliably to detect recurrentpancreatic adenocarcinomas in patients with CA 19-9-positive primary tumors. Combination of CA 19-9 with MDCT or FDGPET-CT is potentially the most accurate approach in detecting pancreatic cancer recurrence.

open access journals, open access scientific research publisher, open access publisher
Select your language of interest to view the total content in your interested language

Viewing options

Flyer image

Share This Article