Dynamic ctDNA monitoring of patient H1003. (A) ctDNA and CEA levels were assessed pre-operatively and postoperatively for patient H1003. H1003 presented with recurrence during colonoscopy and in contrast-enhanced CT. For patient H1003, the TP53 and PIK3CA mutation rate changes in ctDNA are presented at the indicated times, and compared with CEA. The number of days following surgery is indicated on the x-axis is indicated on the x-axis. The VAF values are indicated on the y-axis. (B) CT images of liver metastases in patient H1003, in whom the level of ctDNA was four times compared with other patients in the study without metastases. Images were captured on October 17th, 2016 (30 days after surgery), November 30th, 2016 (43 days after surgery), December 12th, (55 days after surgery) and February 4th, 2017 (98 days after surgery). CT, computed tomography; ctDNA, circulating tumor DNA; CEA, carcinoembryonic antigen; PIK3CA, phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha; TP53, tumor protein P53; VAF, variant allele fraction.