Whole-body positron emission tomography and tumor marker CA125 for detection of recurrence in epithelial ovarian cancer

Murakami, Masaru; Miyamoto, Tomofumi; Iida, Takuya; Tsukada, Hitomi; Watanabe, Masashi; Shida, Masako; Maeda, Haruyoshi; Nasu, Seiji; Yasuda, Seiei; Yasuda, Masanori; Ide, Mitsuru

doi:10.1111/j.1525-1438.2006.00471.x

Cited by 48 publications

(19 citation statements)

References 22 publications

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“…The rates of NPV, specificity, PPV, and sensitivity of planned versus actual treatment reported in this study (83.3, 55.6, 76.9 and 93.0%, respectively) showed a good efficacy of this procedure in planning surgical treatment in advanced recurrent ovarian cases. The false-negative rate (7.1%) observed in this study compares well to data reported in the literature [22, 23, 26] and can be explained with the miliary tumor diffusion on the peritoneal surface and the small amount of ascites in our series. However, the existence of false-negative (n = 3) and false-positive cases (n = 13) with respect to the possibility of optimal cytoreduction should be considered.…”

Section: Discussionsupporting

confidence: 78%

“…In the last years, FDG-PET/CT has been utilized to identify clinically occult recurrent ovarian cancer, inorder to improvethe earlier detection of relapse and consequently increase the possibility of secondary cytoreduction [17,18,19,20,21,22,23,24,25,26]. The accuracy rate has ranged from 70 to 95%, and it is limited by the inability to detect small volume (≤7 mm) disease and the misinterpretation of normal physiological abdominal activity [17, 27].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, a growing body of evidence has been produced for the use of fluorine-18-fluorodeoxyglucose positive emission tomography (FDG-PET) and PET/computed tomography (CT) in the early diagnosis of recurrence in ovarian cancer patients [17,18,19,20,21,22,23,24,25,26]. Nevertheless, this technique is still limited by small nodule carcinosis [17,18,19,20,21,22,23,24,25,26,27]. Moreover, no data are available regarding the ability of FDG-PET/CT to assess diffusion of advanced intra-/retroperitoneal disease, and its correlation with the possibility of complete cytoreduction.…”

Section: Introductionmentioning

confidence: 99%

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A Treatment Selection Protocol for Recurrent Ovarian Cancer Patients: The Role of FDG-PET/CT and Staging Laparoscopy

et al. 2008

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Objective: To investigate the best diagnostic and staging strategy for recurrent ovarian cancer. Methods: The negative predictive value, specificity, positive predictive value, sensitivity, and accuracy rates of the fluorine-18-fluorodeoxyglucose positive emission tomography computed tomography (FDG-PET/CT) and staging laparoscopy in identifying surgically treatable/untreatable patients are assessed in a consecutive series of 70 recurrent ovarian cancer cases. Moreover, the diagnostic performance of each staging procedure in the evaluation of the number of nodules is analyzed. Results: The negative predictive value of the FDG-PET/CT was 83.3%, whereas the positive predictive value was 76.9%. Specificity was 55.6%, whereas sensitivity was 93.0%. Accuracy rate was 78.6%. Negative predictive value, specificity, positive predictive value, sensitivity, and accuracy rate of staging laparoscopy were 88.9, 64.0, 80.8, 95.0 and 83.1%, respectively. Combined radiological and laparoscopic evaluation showed a negative predictive value of 88.9%, a specificity of 59.3%, a positive predictive value of 78.8%, a sensitivity of 95.3%, and an accuracy rate of 81.4%. The number of nodules identified by FDG-PET/CT corresponded in only 23 patients (40.3%) at laparotomy, whereas 15 of 30 patients were correctly diagnosed (50.0%) by staging laparoscopy. Conclusions: The combination of FDG-PET/CT and staging laparoscopy has a significant effect on the multimodal approach to the population of patients with recurrent ovarian cancer. Such techniques should be considered complementary, because of the potential of each one to identify a different setting of the disease.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Treatment Selection Protocol for Recurrent Ovarian Cancer Patients: The Role of FDG-PET/CT and Staging Laparoscopy

et al. 2008

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“…CT sensitivity is reported to be especially low for detection of peritoneal carcinosis and lymphatic metastases which is not so for FDG PET. In this regard, in a series by Murakami et al including 90 patients, FDG PET had a sensitivity for the detection of intraperitoneal and retroperitoneal metas-tases of ovarian cancer of 93.9 and 92.9 %, respectively [42]. Furthermore, FDG PET imaging was able to detect metastases in normal-sized lymph nodes.…”

Section: Ovarian Cancermentioning

confidence: 99%

Serum tumor markers and PET/CT imaging for tumor recurrence detection

et al. 2012

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When confronted with a suspicious rise in CA 15.3 in asymptomatic breast cancer patients following primary treatment and negative or equivocal conventional imaging findings, FDG PET/CT allows assessment of the site and extent of the recurring disease with an accuracy of 83 %. Both FDG PET and FDG PET/CT are superior when compared to CT alone for the purpose of recurrence detection in patients suffering from ovarian carcinoma who have completed primary therapy but demonstrate a rising serum CA-125 level. As the global accuracy of CT alone for detection of recurrence of ovarian cancer approximates 80 %, CT scan should be performed upfront to identify the site of recurrence. When confronted with negative or equivocal CT findings, FDG PET alone or FDG PET/CT should be added. In patients with rising erum CEA levels that have undergone primary treatment for a colorectal carcinoma, both FDG PET and FDG PET/ CTs allow detection of tumor recurrence with an accuracy of 95 %, well above that of CT and MRI. Available studies further suggest that FDG/PET findings will affect treatment management in 28-50 % of these patients. The detection rate of both 11C-choline and 18F-choline PET and PET/CT for local, regional, and distant recurrence in prostate carcinoma patients with a biochemical recurrence increases with rising PSA value at the time of imaging and reaches about 75 % in patients with PSA [3 ng/mL. Furthermore, PET and PET/CT with [11C]-and [18F]-choline derivates may be helpful in the clinical setting for optimization of individualized treatment.

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“…This is useful in cases where conventional imaging fails to detect recurrent disease [27]. FDG-PET may be more useful in detecting recurrence in the setting of negative conventional imaging studies and an increasing CA-125 [28]. In patients with an asymptomatic increase of CA-125, PET has a sensitivity of 87.5%.…”

Section: Ovarian Cancermentioning

confidence: 99%

Role of New Functional MRI Techniques in the Diagnosis, Staging, and Followup of Gynecological Cancer: Comparison with PET-CT

Moreno

Peña²,

Alonso³

2012

Radiology Research and Practice

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Recent developments in diagnostic imaging techniques have magnified the role and potential of both MRI and PET-CT in female pelvic imaging. This article reviews the techniques and clinical applications of new functional MRI (fMRI) including diffusion-weighted MRI (DWI), dynamic contrast-enhanced (DCE)-MRI, comparing with PET-CT. These new emerging provide not only anatomic but also functional imaging, allowing detection of small volumes of active tumor at diagnosis and early disease relapse, which may not result in detectable morphological changes at conventional imaging. This information is useful in distinguishing between recurrent/residual tumor and post-treatment changes and assessing treatment response, with a clear impact on patient management. Both PET-CT and now fMRI have proved to be very valuable tools for evaluation of gynecologic tumors. Most papers try to compare these techniques, but in our experience both are complementary in management of these patients. Meanwhile PET-CT is superior in diagnosis of ganglionar disease; fMRI presents higher accuracy in local preoperative staging. Both techniques can be used as biomarkers of tumor response and present high accuracy in diagnosis of local recurrence and peritoneal dissemination, with complementary roles depending on histological type, anatomic location and tumoral volume.

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Whole-body positron emission tomography and tumor marker CA125 for detection of recurrence in epithelial ovarian cancer

Cited by 48 publications

References 22 publications

A Treatment Selection Protocol for Recurrent Ovarian Cancer Patients: The Role of FDG-PET/CT and Staging Laparoscopy

A Treatment Selection Protocol for Recurrent Ovarian Cancer Patients: The Role of FDG-PET/CT and Staging Laparoscopy

Serum tumor markers and PET/CT imaging for tumor recurrence detection

Role of New Functional MRI Techniques in the Diagnosis, Staging, and Followup of Gynecological Cancer: Comparison with PET-CT

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