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  • 2019-08-14

Circulating Tumor DNA (ctDNA) – A Potential Adjunct to FDG-PET Imaging in Cancer Follow Up

TEACHING POINTS

  • With the continuous advances in healthcare - Next Generation Sequencing and PET-CT are revolutionising cancer diagnostics
  • Survival outcomes in cancer can be improved by early detection of metastatic disease or relapse during follow up
  • Next Generation sequencing is an extremely high end modality wherein hundreds to millions of DNA molecules are sequenced in parallel
  • CtDNA is an application of NGS to monitor the amount of tumor specific DNA in the peripheral blood of patient
  • Using ctDNA, a non-invasive investigation, to monitor the remission status can potentially reduce the frequency of imaging required at follow up, hence reducing the side effects and discomfort
  • According to Wong R et al, for colorectal cancer patients with indeterminate findings on routine investigations, ctDNA detection increases the probability that the findings indicate metastatic disease, including in a nonpredefined subset that also underwent FDG-PET imaging
  • Hence, using ctDNA as an adjunct to FDG-PET imaging during cancer follow-up seems to be an acceptable proposition.

TABLE OF CONTENTS/OUTLINE

  • What is ctDNA? How is it measured?
  • What are the current guidelines for cancer follow up?
  • Review of literature • Advantages and limitations of FDG-PET imaging
  • Advantages and limitations of ctDNA
  • Conclusion

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