TEP au 18-FDG et carcinose péritonéale d’origine ovarienne : valeurs diagnostique et pronostique avant chimio-hyperthermie intra-péritonéale (CHIP)

Zwarthoed, C.; Bereder, Jean Marc; Viau, P.; Grangeon, C.; Maurel, F.; Darcourt, Jacques; Mounier, Nicolas; Razzouk-Cadet, Micheline

doi:10.1016/j.mednuc.2014.05.006

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“…There are some limitations of PET/CT, including the non-specific nature of tracer-uptake, which can accumulate in sites of inflammation and infection, which may be detected as false-positive ( 18 ). In addition, PET/CT has a limited ability to detect small lesions, particularly for those <5 mm, with a false-negative rate of 5–10% ( 19 , 20 ). PET/CT resolution is currently around 4 mm, and even with technical improvements, it cannot drop below 2 mm because the free path of a positron will always leave doubt as to its place of origin ( 21 ).…”

Section: Discussionmentioning

confidence: 99%

Clinical and Survival Impact of FDG PET in Patients with Suspicion of Recurrent Ovarian Cancer: A 6-Year Follow-Up

et al. 2015

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BackgroundThe aim of this retrospective study was to evaluate the contribution of fluorine-18-fluoro-deoxyglucose (FDG) positron emission tomography (PET) to the clinical management and survival outcome of patients (pts) suspected of recurrent ovarian carcinoma, with the hypothesis that early diagnosis of recurrent ovarian cancer may improve overall survival (OS).MethodsFifty-three FDG PET/CT scans were retrospectively analyzed for 42 pts. CT and PET/CT findings were confirmed by imaging and clinical follow-up, and/or pathology, which were considered as the gold standard diagnosis. The treatment plan based on CT staging was compared with that based on PET/CT findings. Medical records were reviewed for pts characteristics, progression-free survival (PFS), and OS. PFS and OS were analyzed using the Cox proportional hazards regression model.ResultsThe final diagnosis of recurrence was established pathologically (n = 16), or by a median clinical follow-up of 6.5 years (range 0.5-7.5) after the PET/CT (n = 37). PET/CT provided a higher detection sensitivity (92.2%, 47/51) than CT (60.8%, 31/51) (p < 0.001). Globally, PET/CT modified the treatment plan in 56.6% (30/53) and in 65.2% (15/23) when the CT was negative prior to PET/CT. In 30 cases, those benefited from a modified treatment plan, these changes led to the intensification of a previous treatment procedure in 83.3% (25/30), and to a reduction in the previous treatment procedure in 16.6% of cases (5/30). The Cox regression multivariate analysis showed that the number of lesions visualized by CT and presence of lung lesions detected by PET/CT were significantly associated with PFS (p = 0.002 and p = 0.035, respectively).ConclusionOn account of its impact on treatment planning, and especially in predicting patient outcome, FDG PET is a valuable diagnostic tool for cases of suspected ovarian cancer recurrence.

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