Characterization of surgically transposed ovaries in integrated PET/CT scan in patients with cervical cancer

Abstract

Transposed ovary in premenopausal women may appear on integrated positron emission tomography/computed tomography scan as a mass with increased 18F-fluorodeoxyglucose uptake, which may be associated with preserved ovarian function. Clinical information regarding transposition should be noted in order not to interpret these as recurrent or metastatic lesions.

18F-FDG PET/CT Findings of Surgically Transposed Ovaries After Radical Hysterectomy in a Young Adult Patient

“…FDG uptake in a transposed ovary can vary with the ovulatory cycle as in normal ovaries. 6 Therefore, if the degree of physiologic uptake in transposed ovaries is intense, differentiating between transposed ovaries and metastases based solely on SUV max is very challenging. In such scenarios, comprehensive information about the clinical course, including imaging findings, is crucial for an accurate diagnosis.…”

“…In this case of cervical adenocarcinoma, which is generally known to have a higher risk of ovarian metastasis compared with cervical squamous carcinoma, the pathological stage was stage IB1, indicating a low risk for ovarian metastasis, 5 and postoperative radiation therapy was not performed in the end. FDG uptake in a transposed ovary can vary with the ovulatory cycle as in normal ovaries 6 . Therefore, if the degree of physiologic uptake in transposed ovaries is intense, differentiating between transposed ovaries and metastases based solely on SUV max is very challenging.…”

“…It is important to keep in mind that focal FDG uptake does not always indicate metastasis in postoperative cervical cancer patients 2,4 . Although the patients’ menstrual cycle cannot be easily estimated after hysterectomy state, radiologists should accurately interpret the imaging findings of transposed ovaries on 18 F-FDG PET/CT to avoid unnecessary treatment of transposed ovaries 6–9 …”