Recurrent Ovarian Cancer: Use of Contrast-enhanced CT and PET/CT to Accurately Localize Tumor Recurrence and to Predict Patients’ Survival

Sala, Evis; Kataoka, Masako; Pandit‐Taskar, Neeta; Ishill, Nicole; Mironov, Svetlana; Moskowitz, Chaya S.; Mironov, Oleg; Collins, Michelle A.; Dennis, S.; Larson, Steven M.; Hricak, Hedvig

doi:10.1148/radiol.10092279

Cited by 65 publications

(36 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Avril et al (22) demonstrated that OC patients responding to chemotherapy showed a longer median OS than non-responders. Only three studies evaluated the prognostic role of PET (7) and PET/CT (23,24) in patients with OC after primary treatment. The results by Kurosaki et al (7) are similar to the present report, showing that the serum CA125 level significantly correlated with the prognosis.…”

Section: Discussionmentioning

confidence: 99%

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

View full text Add to dashboard Cite

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 ...

show abstract

Section: Discussionmentioning

confidence: 99%

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

View full text Add to dashboard Cite

show abstract

“…In fact, the main limitation of CE CT is the reduced sensitivity (~50%) for the detection of peritoneal implants <10 mm (28), or for the differentiation of these from fibrous residual after treatment. However, there are no reliable data which favor PET/CT rather than CE CT and vice versa (29).…”

Section: Discussionmentioning

confidence: 99%

Serum HE4 levels combined with CE CT imaging improve the management of monitoring women affected by epithelial ovarian cancer

et al. 2013

View full text Add to dashboard Cite

Abstract. The aim of the present study was to evaluate human epididymis protein 4 (HE4) as a marker of epithelial ovarian cancer (EOC) relapse and the combination of this biomarker with contrast-enhanced high-resolution multidetector row computed tomography CE CT imaging to impove the monitoring of EOC patients. Twenty-one patients with advanced EOC (FIGO III/IV) who underwent surgery and adjuvant chemotherapy were retrospectively selected. Each patient contributed 3 serum samples drawn at 3-month intervals: time interval I (1-3 months from surgery), time interval II (4-6 months from surgery) and time interval III (7-10 months from surgery). Serum HE4 and cancer antigen-125 (CA-125) levels were determined by EIA and IRMA assays, respectively. Nine out of the 21 (Group A) women had disease relapse while 12 out of the 21 (Group B) women had stable disease during the follow-up study. Twenty out of the 21 patients underwent at least two CE CT follow-ups with an interval time of ~6 months. One patient did not undergo a second CE CT. In patients with relapsed EOC, an increase in HE4 was noted in 22, 78 and 89% of patients within the time intervals I, II and III, respectively. Positivity for CA-125 was found later at time interval III and only in 44% of patients. Conversely, for EOC patients in remission, increase over the threshold level was observed only for marker CA-125 (4/12). The evaluation of imaging findings at interval time II showed a significant correlation with high levels of HE4 in 6 out of 9 patients with recurrent disease. This study supports the hypothesis that HE4 may serve as an early biomarker for recurrence of EOC.Moreover, HE4 serum levels combined with CE CT imaging may improve the monitoring management of women affected by ovarian cancer.

show abstract

“…A total of 10−30 mL saline flush is done after IV FDG injection [26,28]. In order to allow even biodistribution and sufficient cellular uptake of FDG, the patients should not immediately undergo PET/CT after the injection of FDG, but they should rather wait for at least 40−60 min before the scanning [18,26,27,29,30 ]. If it is not possible to place a venous access, FDG can also be administered orally in liquid form with water [16,18].…”

Section: Administration Of Fdgmentioning

confidence: 99%

“…Prior to abdominal PET/CT imaging, diluted iodinated CM or barium sulfate as positive contrast agents are administered orally for the opacification of gastrointestinal system [5,27,29,30,33,34]. Water or water-based negative contrast agents were also recommended as intraluminal CMs since they were reported to help increase the quality of the images with decreased artifacts [35].…”

Section: Administration Of Radiologic Contrast Materialsmentioning

confidence: 99%

Patient Preparation for Oncological FDG-PET/CT Imaging

Ayaz¹

2017

Ann Clin Anal Med

View full text Add to dashboard Cite

Recurrent Ovarian Cancer: Use of Contrast-enhanced CT and PET/CT to Accurately Localize Tumor Recurrence and to Predict Patients’ Survival

Cited by 65 publications

References 31 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

Serum HE4 levels combined with CE CT imaging improve the management of monitoring women affected by epithelial ovarian cancer

Patient Preparation for Oncological FDG-PET/CT Imaging

Contact Info

Product

Resources

About