Accuracy of Positron Emission Tomography/Computed Tomography in the Diagnosis and Restaging for Recurrent Ovarian Cancer

Zhao, Limei; Yong, Chen; Xu, Yan; Tang, Shuai; Jiangyan, Xie; Liang, Zhiqing

doi:10.1097/igc.0b013e31828a183c

Cited by 55 publications

(26 citation statements)

References 25 publications

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“…[11,12] A recent meta-analysis of 29 studies demonstrated that PET-CT had high sensitivity (89%) and specificity (90%). [13] Some reports have shown that management plans tended to change after examination of PET scans. [14,15] Fulham mentioned that the management plans in 58.9% of patients changed based on PET scan findings.…”

Section: Discussionmentioning

confidence: 99%

Impact of FDG PET in optimizing patient selection for cytoreductive surgery in recurrent ovarian cancer

Ebina

Watari

Kaneuchi

et al. 2013

Eur J Nucl Med Mol Imaging

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Purpose. To investigate the impact of PET and PET-CT scanning on decision-making in the management plans and to identify the optimal setting for selecting candidate for surgery in suspicious recurrent ovarian cancer. Results. After PET scanning, the management plan was changed on 52 of 89 occasions (58.4%). The total number of cytoreductive surgeries selected as a treatment choice increased from 12 to 35. Miliary disseminated disease, which was not detected by PET scan, was found in 22.2% of surgeries. Miliary disseminated disease was detected in 6 of the 12 recurrent cases whose treatment-free interval (TFI) <12 months, whereas none of those with a TFI ≥12 months had such disease (p=0.0031). MethodsConclusions. PET or PET-CT is useful for selecting cytoreductive surgery candidates among patients with recurrent ovarian cancer. To avoid surgical attempts at miliary dissemination, patients with TFI ≥12 months are the best cytoreducive surgery candidates.

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Section: Discussionmentioning

confidence: 99%

Impact of FDG PET in optimizing patient selection for cytoreductive surgery in recurrent ovarian cancer

Ebina

Watari

Kaneuchi

et al. 2013

Eur J Nucl Med Mol Imaging

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“…Despite possible declinations in preoperative assessment of peritoneal metastasis dissemination from the accurate picture, this method gives the opportunity to adequately carry out the selection of patients for surgical treatment. 14,15 Figure 2 CT image of solid oval implant of homogenous structure, 27х16mm in douglas space. …”

Section: Resultsmentioning

confidence: 99%

The Efficiency of CT at Pre-Operative Evaluation Stage of PCI in Patients with Recurrent Ovarian Cancer

Hural¹,

Mylyan²,

Fetsych³

et al. 2017

IJRRT

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The CT imaging of abdomen and pelvic region with contrast enhancement using one slice spiral computed tomography Somatom Emotion (Siemens, Germany) was performed. The retrospective analysis of the results of pre-operative CT in 32 patients with advanced ovarian cancer and peritoneal canceromatosis was carried out/implemented. Within this population the average age was 53,2±6years. Out of the 32 patients, 7 had stage FIGO II, 24 had stage FIGO III and 1 had stage FIGO IV. Due to the histological subtypes the ovarian cancer had the following distribution: serous papillary carcinoma in 27(24,4%), clear cell in 1(3,1%), papillary carcinoma in 1(3,1%) and mucinous adenocarcinoma in 3(9,4%) patients. Cytoreductive therapy for all patients was held. Thus, six cycles of chemotherapy protocol CP (cyclophosphamide 750mg/m 2 and cisplatin 75mg/m2) or PC (paclitaxel 175mg/m and carboplatin auc 5) were held. 8 patients underwent neoadjuvant chemotherapy (3 cycles CP), cytoreductive surgical therapy with further adjuvant chemotherapy. 17 patients showed disease progression in more than 12months (clinically sensitive to platinum derivatives). In 8 patients disease progression less than a year after the end of treatment was diagnosed. 25 patients underwent surgical treatment of recurrent tumor with following chemotherapy using platinum derivatives if sensitivity to the drug was present. In case of moderate sensitivity to platinum derivatives after surgical treatment the chemotherapy of 2 nd line was applied. While planning primary and repetitive cytoreductive therapy CT of the abdomen and pelvis using one slice spiral CT «Somatom Emotion» («Siemens», Germany) with spiral type scan axial plane was performed. 5-10 Technical parameters of the scan were: voltage -130kV, current -11mA, spiral step-3.0-5.0mm, tube rotation time -1.0sec. Intravenous and oral contrast enhancement to improve visualization of the pathological process was performed. For intravenous contrast enhancement water-soluble low osmolarity radiocontrast agent (iohexol, iopromide) with the calculation of 1.4ml per kg body weight of the patient was used. Gastrointestinal tract was filled with water-soluble high ocmolarity radiocontrast agents or other negative (water) solutions. While detecting of peritoneal carcinomatosis implants location and size of the latter were evaluated. After CT was performed all patients were operated. The average time between CT and surgery was 17days. The true data of the distribution and the implants' size were received during the surgical revision of the abdomen and pelvis, which was in detail recorded during the surgery. Comparing the CT results with the data of intraoperative revision, the P. Sugarbaker's classification of peritoneal carcinomatosis index (PCI) was used.11 According to the latter abdomen is divided conditionally with two horizontal and two vertical lines into nine quadrants, small intestine -along into four parts (proximal and distal parts of jejunum and ileum), in total 13 sites. In each area the size of the largest ...

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“…The use of FDG-PET/CT has been previously described to assess recurrent ETOC patients, in order to exclude extra-abdominal disease and to evaluate retroperitoneal and/or intraparenchymal disease [20,21,22,23]. The accuracy rate of FDG-PET/CT has ranged from 70 to 95%, and it is limited by the inability to detect small volume (<7-10 mm) disease [20,21,22,23]. Thus, diffuse recurrent carcinosis consisting of multiple nodules of a few millimeters could be overlooked by FDG-PET/CT, leading to inappropriate surgical explorations.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Splenectomy as Quaternary Cytoreduction for Isolated Parenchymal Splenic Recurrence of Epitelial Tubo-Ovarian Cancer: Report of a Case and Literature Review

Sorbi¹,

Prosperi²,

Villanucci³

et al. 2015

Gynecol Obstet Invest

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Isolated parenchymal splenic lesions are very rare and may occur as recurrences in the form of epithelial tubo-ovarian cancer (ETOC). We report a case of solitary parenchymal splenic recurrence of ETOC, which developed 50 months after the initial treatment. A 66-year-old woman underwent laparotomic primary cytoreduction in 2008. After platinum-based chemotherapy, she developed recurrences; thus, she underwent secondary and tertiary cytoreduction in 2011 and 2012 respectively. In April 2013, CT scan documented a solitary parenchymal splenic lesion and it was confirmed by FDG PET/CT. She underwent quaternary cytoreduction by laparoscopic splenectomy. Histopathological evaluation revealed metastatic parenchymal disease consistent with recurrent ETOC. She was alive and disease-free for ten months since splenectomy. In literature there are 35 cases of isolated spleen parenchymal metastasis of ETOC and our report is the first case of laparoscopic splenectomy in the setting of quaternary cytoreduction. Laparoscopic splenectomy as quaternary cytoreduction is safe and feasible and could be congruent to the well-established experiences already reported for the primary, secondary or even tertiary cytoreduction where the absence of residual disease has been translated in a significant survival benefit.

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Accuracy of Positron Emission Tomography/Computed Tomography in the Diagnosis and Restaging for Recurrent Ovarian Cancer

Abstract: Positron emission tomography/computed tomography is a useful tool for predicting the diagnosis and restaging of suspected recurrent ovarian carcinoma.

Cited by 55 publications

References 25 publications

Impact of FDG PET in optimizing patient selection for cytoreductive surgery in recurrent ovarian cancer

Impact of FDG PET in optimizing patient selection for cytoreductive surgery in recurrent ovarian cancer

The Efficiency of CT at Pre-Operative Evaluation Stage of PCI in Patients with Recurrent Ovarian Cancer

Laparoscopic Splenectomy as Quaternary Cytoreduction for Isolated Parenchymal Splenic Recurrence of Epitelial Tubo-Ovarian Cancer: Report of a Case and Literature Review

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