Published in:
01-10-2014 | Computed Tomography
Elevated serum CA 19-9 at screening tests: underlying conditions and role of abdominopelvic CT
Published in: European Radiology | Issue 10/2014
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Objectives
To investigate underlying conditions of patients with elevated CA 19-9 at screening tests and to evaluate diagnostic performance of abdominopelvic CT.
Methods
One hundred and thirteen patients with elevated CA 19-9 (>37 U/ml) who underwent abdominopelvic CT in a screening program were selected. Underlying conditions were determined by reviewing all available data and follow-up records. Patients were categorized into malignancy, benign, and normal/non-related disease groups. Their mean CA 19-9 and percent of patients with CA 19-9 ≥ 100 U/ml were compared. Diagnostic sensitivity of CT for detecting underlying conditions of elevated CA 19-9 was analysed.
Results
Seventeen patients (17/113, 15 %) had 17 elevated CA 19-9-related malignancies, and 55 patients (55/113, 48.7 %) had 70 benign diseases. Mean CA 19-9 and percent of patients with CA 19-9 ≥ 100 U/ml in the malignancy group were significantly higher than in the two other groups. CT detected all except one malignant lesion with a detection sensitivity of 94.1 % (16/17). Of 70 CA 19-9-related benign diseases, CT detected 34 benign diseases (48.6 %) providing an alternative diagnosis for elevated CA 19-9.
Conclusion
Abdominopelvic CT is not only useful in detecting malignancies, but can also diagnose alternative benign causes of elevated CA 19-9 in asymptomatic screening tests.
Key Points
• Fifteen percent of asymptomatic patients with elevated CA19-9 may have intra-abdominal malignancies.
• Mean value of CA19-9 is different among malignant, benign, and non-related groups.
• CT shows excellent sensitivity for intra-abdominal malignancies as causatives of elevated CA19-9.
• CT provides alternative benign diagnoses as causatives of elevated CA19-9.
• Detection of causatives of elevated CA19-9 using CT alleviates concerns and uncertainty.