Clinical value of FDG PET/CT in the diagnosis of suspected recurrent ovarian cancer: is there an impact of FDG PET/CT on patient management?

Bılıcı, Ahmet; Ustaalıoğlu, Bala Başak Öven; Şeker, Mesut; Canpolat, Nur; Tekinsoy, Bülent; Salepçi, Taflan; Gümüş, Mahmut

doi:10.1007/s00259-010-1416-2

Cited by 45 publications

(28 citation statements)

References 40 publications

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“…In accordance with our results, we found that the inclusion of PET/CT in the management of patients with recurrent ovary cancer had an impact on the decision making in 42% of subjects. As reported in the literature, the change in management of patients with OC who have undergone FDG PET/ CT ranges between 25% and 58% (10,(15)(16)(17)(18). OC can disseminate to the peritoneum.…”

Section: Discussionmentioning

confidence: 97%

Diagnostic and prognostic evaluation of fluorodeoxyglucose positron emission tomography/computed tomography and its correlation with serum cancer antigen-125 (CA125) in a large cohort of ovarian cancer patients

Evangelista

Palma

Gregianin

et al. 2015

J Turkish German Gynecol Assoc

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Ovarian cancer (OC) accounts for approximately 3% of cancers in women; 125,000 women are estimated to die of the disease each year. OC is curable when identified at an early stage. However, because there is no effective screening test for this tumor and its symptoms are vague, approximately 70-80% of patients are diagnosed at an advanced stage of the disease (stage III and IV, in accordance with the International Federation of Gynecology and Obstetrics (FIGO)); this means that the survival rate is low (1). More than 70% of stage III-IV patients have a relapse of the disease, and even in stage I or II, the relapse rate is 20-25% (2). The serial evaluation of serum cancer antigen-125 (CA125) can be useful to non-invasively detect the recurrence of disease because an elevation in CA125 levels can determine the presence of disease with a high accuracy of 79% to 95%, thus preceding a clinically apparent recurrence by 3 to 6 months (3, 4). However, normal CA125 levels cannot exclude the presence of recurrent Objective: We evaluated the efficacy of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in recurrent disease, response to therapy, and long-term follow-up of ovarian cancer (OC) patients in relation to cancer antigen-125 (CA125) levels and the prognostic meaning of this modality in this subset of subjects. Material and Methods:Between 2005 and 2015, we retrospectively evaluated 125 patients affected by OC who underwent FDG PET/CT imaging at our institution. The indications for PET/CT were recurrence of disease in 78 patients, therapy response assessment in 29, and follow-up in 18. The results of FDG PET/CT were compared with those of histopathology and clinical and radiological progression during follow-up for at least 6 months. The median long-term follow-up was 33 months. The diagnostic accuracies for the different clinical settings were evaluated. The relationships among global survival (GS), FDG PET/CT results, and CA125 levels were evaluated by both Kaplan-Meier and Cox regression analysis.Results: CA125 results were positive (>35 UI/mL) in 62 patients and negative in 63 (49% vs. 51%). The sensitivity and specificity of CA125 were 72% and 91%, respectively. PET/CT imaging showed a sensitivity of 98.6% and a specificity of 77.8% for the assessment of recurrent disease, and a sensitivity of 72.7% and a specificity of 88.9% for therapy evaluation. Meanwhile, in 18 patients evaluated during follow-up, the specificity was 82.3%. GS was significantly higher in case of negative CA125 values at the time of FDG PET/CT, of a negative PET/CT scan and when no evidence of peritoneum recurrence and distant metastases was determined by PET. Multivariate regression analysis showed that only age and peritoneum recurrence as determined by PET were identified as independent predictors of poor prognosis. Conclusion:Metabolic imaging with FDG PET/CT proved useful in patients where OC recurrence was suspected, even when the value of tumor marker CA125 was in a normal range. A positive PET/CT ...

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Section: Discussionmentioning

confidence: 97%

Diagnostic and prognostic evaluation of fluorodeoxyglucose positron emission tomography/computed tomography and its correlation with serum cancer antigen-125 (CA125) in a large cohort of ovarian cancer patients

Evangelista

Palma

Gregianin

et al. 2015

J Turkish German Gynecol Assoc

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“…Generally, the diagnostic performance indices of combined PET/CT come in line with those reported in literature. (24)(25)(26)(27) However, the sensitivity of Ce-CT is generally higher than others reported in literature. (24, 25, 28, 29) .…”

Section: Discussionmentioning

confidence: 84%

Role of 18F-FDG PET/CT in the Detection of Ovarian Cancer Recurrence in the Setting of Elevated Tumor Markers

2014

The Egyptian Journal Nuclear Medicine

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Objectives: To evaluate the diagnostic performance of 18 F-flurodeoxyglucose positron emission tomography/ computed tomography in patients with suspected biochemical ovarian tumor recurrence in comparison to contrast enhanced CT. Patients and Methods: A total of 64 18 F-FDG PET/CT studies for patients with biochemical suspicious ovarian tumor recurrence were evaluated. Each patient underwent 18 F-FDG PET/CT and Ce-CT scans in the same day. Studies were read independently by one experienced nuclear medicine physician and one experienced radiologist. A four-point score (score 0 = definitely benign, score 1 = probably benign, score 2 = probably malignant and score 3 = definitely malignant) used to assess the presence or absence of recurrence (local, regional or distant).The final diagnosis of tumor status was made on the basis of subsequent followup by 18 F-FDG PET/CT, conventional imaging (CT/MRI) or histopathology whenever possible. Results: Of the 64 studies evaluated, 61 (95%) studies had tumor recurrence and 3 (5%) studies were free based on final diagnosis.18 F-FDG PET/CT & Ce-CT had sensitivity 97% vs. 87%, specificity 100% vs. 33%, and accuracy of ( 97% vs. 84% ) respectively. 18 F-FDG PET/CT was significantly more sensitive and more accurate compared to Ce-CT with P-value of 0.07 and 0.02; respectively with no statistical significant difference in accuracy.Conclusions:18 F-FDG PET/CT is more accurate than Ce-CT in the diagnosis of ovarian tumor recurrence in patients with elevated tumor marker.

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“…Lors de la suspicion de récidive (devant une élévation du marqueur CA 125 ou des signes cliniques d'appel), elle a démontré une valeur diagnostique satisfaisante et même meilleure que les méthodes d'imagerie conventionnelle dans cette indication [6][7][8][9]. Dans une cohorte prospective de 90 patientes, on a ainsi pu observer un impact sur la prise en charge des patientes dans 60 % des cas [10].…”

Section: Introductionunclassified

TEP au 18-FDG et carcinose péritonéale d’origine ovarienne : valeurs diagnostique et pronostique avant chimio-hyperthermie intra-péritonéale (CHIP)

Zwarthoed¹,

Bereder

Viau³

et al. 2014

Médecine Nucléaire

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Clinical value of FDG PET/CT in the diagnosis of suspected recurrent ovarian cancer: is there an impact of FDG PET/CT on patient management?

Cited by 45 publications

References 40 publications

Diagnostic and prognostic evaluation of fluorodeoxyglucose positron emission tomography/computed tomography and its correlation with serum cancer antigen-125 (CA125) in a large cohort of ovarian cancer patients

Diagnostic and prognostic evaluation of fluorodeoxyglucose positron emission tomography/computed tomography and its correlation with serum cancer antigen-125 (CA125) in a large cohort of ovarian cancer patients

Role of 18F-FDG PET/CT in the Detection of Ovarian Cancer Recurrence in the Setting of Elevated Tumor Markers

TEP au 18-FDG et carcinose péritonéale d’origine ovarienne : valeurs diagnostique et pronostique avant chimio-hyperthermie intra-péritonéale (CHIP)

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