Abstract
Objective To investigate the diagnostic accuracy of malignant tumor of 18F-fluorodeoxyglucose positron emission tomography/computed tomograprhy (18F-FDG PET/CT) imaging in the patients of elevated serum carbohydrate antigen 19-9 (CA19-9) and its correlation with maximum standardized uptake value (SUVmax) and serum CA19-9 level. Methods Whole-body 18F-FDG PET/CT scan was performed in 149 patients with elevated serum CA19-9 level without the history of malignancy. Blood sample was drawn in each case for CA19-9 assay two weeks or less before the performing PET/CT. Final diagnoses were confirmed by operation/biopsy pathological results and clinical follow-ups. Results Among the 149 patients, 64 cases were finally diagnosed as malignancies and 85 cases of non-malignancy diseases. The true positive of the diagnoses by 18F-FDG PET/CT was 60 cases, the false positive 13 cases, the true negative 72 cases, the false negative 4 cases. The accuracy of diagnosis of malignant tumor with elevated serum CA19-9 was 43.0%, while elevated serum CA19-9 combined with 18F-FDG PET/CT imaging was 88.6%, with statistically significant difference (χ2=59.882, P 1 000 U/ml. The diagnostic accuracy of each group of PET/CT was 94.5%, 84.9%, 81.3% and 88.0%, respectively. There was no statistically significant difference between each group (χ2=3.503, P>0.05). The area under the curve (AUC) of the serum CA19-9 for the diagnosis of malignant tumor (ROC) was 0.726, and the sensitivity and specificity of the diagnostic boundary value of 152.75 U/ml were 70.3% and 68.2%, respectively. The AUC of SUVmax in diagnosis of malignant tumor was 0.742, the best cutoff value was 6.95, and the sensitivity and specificity were 73.3%, 69.2% respectively. Conclusions 18F-FDG PET/CT is useful for detecting malignant tumors combined with serum tumor marker CA19-9. The patients with elevated serum CA19-9 are necessary to do PET/CT imaging, especially serum CA19-9>152.75 U/ml. And it should be considered malignant tumor when SUVmax>6.95. Key words: Neoplasms/DI; CA-19-9 antigen/BL; Tomography, emission-computed; Tomography, X-ray computed; Fluorodeoxyglucose F18
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