Diagnostic accuracy of 18F-FDG PET/CT scan for peritoneal metastases in advanced ovarian cancer

Abstract

Background: To assess the diagnostic accuracy of 18 F-FDG PET/CT to determine the Eisenkop score and peritoneal cancer index (PCI) in correlation with surgical findings.Methods: Forty-three patients underwent preoperative 18 F-FDG PET/CT scan, followed by primary cytoreductive surgery for advanced ovarian cancer between September 2015 and February 2018. Clinical data were prospectively collected, including intraoperative assessment (with Eisenkop and PCI scores) and surgical results. The sensitivity, specificity, and accuracy were calculated at each anatomical site. The Eisenkop score, PCI score, and tumor volume of PET/CT scans were compared with surgical findings.Results: A total of 32 (74.4%) patients were diagnosed with stage III, and 11 (25.6%) patients were stage IV. Among these individuals, 19 (44.2%) patients had no residual disease after primary surgery. The median[range] Eisenkop score on PET/CT scans and surgical findings were 5 [1-13] and 6 [2-13], respectively.PET/CT scans correctly predicted the Eisenkop score with high sensitivity (84.2%), specificity (87.0%), and accuracy (85.1%). The diagnostic accuracy of PET/CT scans for PCI scores was lower (78.5%), with 72.7% sensitivity and 84.9% specificity. Preoperative PET/CT scans might underestimate tumor volume compared with surgical findings.Conclusions: 18 F-FDG PET/CT scans accurately predicted peritoneal metastases in advanced ovarian cancer before surgery using Eisenkop score.

Imaging of Peritoneal Metastases in Ovarian Cancer Using MDCT, MRI, and FDG PET/CT: A Systematic Review and Meta-Analysis

“…Following a review of the titles and abstracts, 187 studies were selected as potentially relevant, and their references were cross-checked. Thirty-three publications eventually fulfilled the inclusion criteria and were selected for quantitative synthesis (Table 2) [26,27,30,42,44,. The flow chart of the selection process is shown in Figure 2.…”

“…The hypermetabolic activity of PMs increases their conspicuity using FDG PET/CT. CT and FDG PET/CT are considered equivalent alternatives for the detection of recurrent OC [1, 17,30,[36][37][38][39][40][41][42][43][44]. Based on the results of a recently published meta-analysis, FDG PET/CT had high diagnostic accuracy, with 88% sensitivity and 89% specificity in the detection of recurrent OC [45].…”

18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) predictive score for complete resection in primary cytoreductive surgery

“…Previous studies11 15 have investigated the peritoneal cancer index score on 18 F-FDG PET/CT. Regions corresponding to the small bowel (9-12) have the lowest accuracy on 18 F-FDG PET/CT.…”

Prediction of Surgical Outcome in Advanced Ovarian Cancer by Imaging and Laparoscopy: A Narrative Review

“…For characterizing complex adnexal masses owing to the high rate of false positive and false negative findings, PET/CT is of no advantage [ 117 , 126 ]. PET/CT is commonly used in staging of ovarian cancer as a problem-solving modality in indeterminate supra-diaphragmatic lesions and retroperitoneal lymph node involvement ( Table 4 , Figure 10 ) [ 54 , 109 , 112 , 113 , 114 , 127 , 128 , 129 ].…”