Positron Emission Tomography/Computed Tomography in Platinum-sensitive Recurrent Ovarian Cancer: A Single-center Italian Study

Gadducci, Angiolo; Simonetti, Enrico; Manca, Gianpiero; Guidoccio, Federica; Fanucchi, A; Cosio, Stefania; Volterrani, Duccio

doi:10.21873/anticanres.14180

Cited by 9 publications

(19 citation statements)

References 20 publications

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“…Another early report by Dirisamer et al indicated a higher sensitivity and specificity of PET/ceCT over PET/ldCT at the peritoneal level, in a small series of patients [27]. However, a recent series analysis by Gadducci et al could not confirm these results: both methods showed excellent sensitivity and accuracy at the patient level and performed relatively poorly in the detection of peritoneal deposits; the integration of ceCT to the PET examination brought no specific benefit [30]. In summary, although the PET/CT method and its combination with ceCT have been used for more than two decades, only a few studies performed a head-to-head comparison between the two diagnostic procedures.…”

Section: Discussionmentioning

confidence: 95%

“…Some reports indicate that performing an 18 F-FDG PET with a full-dose CT and contrast medium might grant a better accuracy than 18 F-FDG PET with low-dose, non-contrast CT [27][28][29]. However, recent evidence was not able to confirm that using contrast medium and diagnostic settings significantly affect the accuracy of 18 F-FDG PET/CT [30]. In general, the use of "radiological" settings and contrast medium in CT has been debated for a long time; the consensus leans toward the possible usefulness of this technique in the context of abdominal lesions [31,32].…”

Section: Introductionmentioning

confidence: 99%

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To Enhance or Not to Enhance? The Role of Contrast Medium 18F-FDG PET/CT in Recurrent Ovarian Carcinomas

et al. 2021

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Background and Objectives: 18F-fluorodeoxyglucose (FDG) positron emission tomography/X-ray computed tomography (PET/CT) represents the mainstay diagnostic procedure for suspected ovarian cancer (OC) recurrence. PET/CT can be integrated with contrast medium and in various diagnostic settings; however, the effective benefit of this procedure is still debated. We aimed to compare the diagnostic capabilities of low-dose and contrast-enhanced PET/CT (PET/ldCT and PET/ceCT) in patients with suspected ovarian cancer relapse. Materials and Methods: 122 OC patients underwent both PET/ldCT and PET/ceCT. Two groups of nuclear medicine physicians and radiologists scored the findings as positive or negative. Clinical/radiological follow-up was used as ground truth. Sensitivity, specificity, negative/positive predictive value, and accuracy were calculated at the patient and the lesion level. Results: A total of 455 and 474 lesions were identified at PET/ldCT and PET/ceCT, respectively. At the lesion level, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were not significantly different between PET/ldCT and PET/ceCT (98%, 93.3%, 97.4%, 94.9%, and 96.9% for PET/ldCT; 99%, 95.5%, 98.3%, 97%, and 98% for PET/ceCT, p = ns). At the patient level, no significant differences in these parameters were identified (e.g., p = 0.22 and p = 0.35 for accuracy, in the peritoneum and lymph nodes, respectively). Smaller peritoneal/lymph node lesions close to physiological FDG uptake sources were found in the cases of misidentification by PET/ldCT. PET/ceCT prompted a change in clinical management in four cases (3.2%) compared to PET/ldCT. Conclusions: PET/ceCT does not perform better than PET/ldCT but can occasionally clarify doubtful peritoneal findings on PET/ldCT. To avoid unnecessary dose to the patient, PET/ceCT should be excluded in selected cases.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

To Enhance or Not to Enhance? The Role of Contrast Medium 18F-FDG PET/CT in Recurrent Ovarian Carcinomas

et al. 2021

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“…Studies have shown that PET-CT is especially useful for detecting recurrent ovarian cancer 18 19. In the period 2012–2016, when the patients in this study were recruited, only a few Norwegian hospitals had a PET scanner, which likely explains why this modality was used to detect recurrence in only 3% of patients.…”

Section: Discussionmentioning

confidence: 98%

Symptomatic or asymptomatic recurrence of ovarian cancer: does it influence survival?

Madland

Bjørge

Småstuen

et al. 2022

Int J Gynecol Cancer

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ObjectiveThe survival benefit of monitoring CA125 in ovarian cancer patients after primary treatment is debated due to findings varying from insignificant survival differences to prolonged median overall survival in favor of asymptomatic patients. Hence we aimed to compare ovarian cancer patients with and without symptoms at the time of the first diagnosed recurrence in terms of post-recurrence survival and overall survival, and to explore time to recurrence and common symptoms at recurrence.MethodsWe included 421 women with ovarian cancer from a prospective multi-institutional Norwegian study of first recurrence of gynecological cancer over the period from March 2012 to April 2016. Patients were interviewed by clinicians at participating hospitals, and patient reported and clinical variables were recorded in a standardized questionnaire. The Kaplan–Meier method and the multivariate Cox model were used to evaluate post-recurrence survival and overall survival.ResultsOf the 406 patients included, 183 (45%) patients were diagnosed with asymptomatic recurrence, and 223 (55%) patients had symptoms at recurrence. Asymptomatic patients had their recurrence detected 2 months later than symptomatic patients (14 vs 12 months, respectively, p=0.17). Median post-recurrence survival was significantly longer in asymptomatic patients compared with patients with symptoms at recurrence (33.9 vs 26.2 months, respectively, p=0.002). The post-recurrence survival rate remained higher for symptomatic patients in the adjusted analysis (hazard ratio (HR)=1.42, p=0.001). Median overall survival was 47.8 months for asymptomatic patients versus 44.0 months for symptomatic patients in the unadjusted analyses (p=0.056). Asymptomatic patients had a significantly longer survival in the adjusted analysis (HR=1.24, p=0.046). Pain was the most common symptom at recurrence (54%).ConclusionPatients with asymptomatic recurrence had a better prognosis based on post-recurrence data and the multivariate Cox regression analysis of overall survival. However, a closer exploration of differences in development of recurrence is needed as these results may give rise to more individualized follow-up for ovarian cancer patients.

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“…e appearance of human changes with age. e surface of the young girl is smooth and uneven due to multiple ovulations after adolescence; the maximum postmenopausal volume of the ovary decreases during the sexual maturity [16]. Research shows that ovarian tumor is one of the common tumors of female genitalia [17], and its malignant tumor is the tumor with the highest mortality among gynecological malignancies.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, accuracy was used to represent the proportion of all predictions that were correct. e specific calculation method was shown in equation (15); Precision meant that all predictions were the ratio of positive examples where the actual labels were positive examples, and the specific calculation method was shown in equation (16). Recall was the ratio at which the positive sample was found, which could be calculated with equation (17).…”

Section: Evaluation Indicatorsmentioning

confidence: 99%

Computed Tomography Image Based on Intelligent Segmentation Algorithm in the Diagnosis of Ovarian Tumor

Zhu

et al. 2021

Scientific Programming

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This study was to explore the application of computed tomography (CT) images based on intelligent segmentation algorithms in the analysis of ovarian tumors, so as to provide a theoretical basis for clinical diagnosis of ovarian tumors. In this study, 100 patients with ovarian tumors were selected as the research objects and performed CT imaging examinations; a convolutional neural networks (CNN) algorithm model was constructed and applied to CT diagnostic image segmentation of patients with ovarian tumors, so as to analyze the effectiveness of the proposed algorithm for CT image segmentation. As a result, the image was segmented three times under the CNN algorithm, and the numbers of true positives (TP) were 50, 49, and 50, respectively; the numbers of false positives (FP) were 1, 2, and 1, respectively; the numbers of false negatives (FN) were 2, 3, and 2, respectively; and the numbers of true negatives (TN) were 47, 46, and 47, respectively. Thus, there was no great difference in the three measured values P ≥ 0.05 . The accuracy of the CNN algorithm was 0.97, 0.95, and 0.97, respectively, for the three times of segmentation; the precision was 0.98, 0.96, and 0.98, respectively; the recall was 0.96, 0.94, and 0.96, respectively. Thus, the accuracy, precision, and recall of the three measurements were not greatly different P ≥ 0.05 . In addition, the F1 values of three measurements were 0.97, 0.94, and 0.97, respectively, which all were close to 1, showing no statistically great difference P ≥ 0.05 . The segmentation accuracy, precision, and recall of the algorithm in this study were greatly greater than the SE-Res Block U-shaped CNN algorithm, and the density peak clustering algorithm, and the differences were statistically significant P < 0.05 . In short, the CNN algorithm showed high accuracy, precision, recall, and comprehensive evaluation values for CT image segmentation, which made the diagnosis of malignant or benign ovarian tumors more effective and provided reliable theoretical guidance for clinical analysis of ovarian tumors.

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Positron Emission Tomography/Computed Tomography in Platinum-sensitive Recurrent Ovarian Cancer: A Single-center Italian Study

Cited by 9 publications

References 20 publications

To Enhance or Not to Enhance? The Role of Contrast Medium 18F-FDG PET/CT in Recurrent Ovarian Carcinomas

To Enhance or Not to Enhance? The Role of Contrast Medium 18F-FDG PET/CT in Recurrent Ovarian Carcinomas

Symptomatic or asymptomatic recurrence of ovarian cancer: does it influence survival?

Computed Tomography Image Based on Intelligent Segmentation Algorithm in the Diagnosis of Ovarian Tumor

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