The role of FDG-PET/CT in ovarian cancer patients with high tumor markers or suspicious lesion on contrast-enhanced CT in evaluation of recurrence and/or in determination of intraabdominal metastases

Rev Esp Med Nucl Imagen Mol. 2012 Jan-Feb;31(1):3-8. doi: 10.1016/j.remn.2011.03.008. Epub 2011 May 6.

Abstract

Objectives: This retrospective study was designed to investigate the role of fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in determination of recurrence and/or intraabdominal metastasis in patients with ovarian cancer having increased tumor markers or suspicious lesion detected by a contrast-enhanced abdominal CT (ceCT).

Materials and methods: A total of 34 female patients who were treated for histopathologically proven ovarian cancer, underwent PET/CT examination for restaging and suspected recurrence. Patients with pathology report, tumor marker levels, ceCT and PET/CT performed within one month were included in the study.

Results: A total of 34 patients were included in the study. 25 of 34 patients had high tumor marker (CA 125) level. The remaining 9 patients had suspected recurrence on ceCT imaging with normal tumor marker levels. Recurrence was confirmed by re-operation and biopsy (n=4), clinical and imaging follow-up (n=21) in 25 patients with elevated tumor markers. Recurrent disease was not shown in 5 of 25 patients on ceCT imaging and 1 of 25 patients on PET/CT imaging with high CA125 values. Both ceCT and PET/CT revealed recurrent disease in 19 of 25 patients. PET/CT showed more lesions in 11 of 19 patients. Sensitivity, specificity and accuracy of the PET/CT were 96.1%, 100% and 97%, respectively.

Conclusion: PET/CT is found as a beneficial method for detection of the recurrence, in patients with increased serum CA 125 level and negative CT findings or with normal CA 125 level and recurrence detected by CT which was performed due to clinical symptoms.

MeSH terms

  • Abdominal Neoplasms / diagnostic imaging*
  • Abdominal Neoplasms / secondary*
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / blood
  • CA-125 Antigen / blood
  • Contrast Media
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Middle Aged
  • Multimodal Imaging*
  • Neoplasm Recurrence, Local / blood
  • Neoplasm Recurrence, Local / diagnostic imaging*
  • Ovarian Neoplasms / blood
  • Ovarian Neoplasms / diagnostic imaging*
  • Ovarian Neoplasms / pathology*
  • Positron-Emission Tomography*
  • Radiopharmaceuticals*
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods

Substances

  • Biomarkers, Tumor
  • CA-125 Antigen
  • Contrast Media
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18