Usefulness of PET–CT in the evaluation of suspected recurrent ovarian carcinoma

Abstract

Background:The purpose of the current study is to assess the PET/CT potential value in the diagnosis of ovarian cancer recurrence.Results: PET/CT scan described suspicion of ovarian cancer (OC) recurrence in 20 local pelvic lesions with 100% sensitivity, accuracy, and specificity and in 18 peritoneal lesions with sensitivity and specificity of 76.19 and 95.65 and accuracy of 89.55%. While PET/CT suspected OC recurrence in 5 pelvic, 9 para-aortic, and 10 distant lymph nodes, the sensitivity, specificity, and accuracy were (80, 98.38, and 97 %), (66.67, 94.82, and 91.04%), and (90, 98.24, and 97.01), respectively. PET/CT scan described suspicion of OC recurrence in 5 distant organ metastases; the accuracy, sensitivity, and specificity were 100%. The lesion-based accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of PET/CT scan were 95.77, 85.7, 97.89, 90.5 and 97% while the corresponding patient-based values were 94.44, 96.87, 75, and 94.44% and 96.87 and 75%. Conclusion: PET-CT is a helpful modality in the assessment of OC recurrence; it can detect and localize the recurrence with high accuracy, thus can influence and modify the treatment plan, and reduces the need for 2nd look surgery.

The role of PET/CT with fluorine-18-deoxyglucose in the detection of relapsed serous ovarian cancer in patients with normal serum CA125 levels

“…Among 31 patients in our study group, we achieved 93.75% sensitivity and 80.00% specificity in diagnosing the recurrence of ovarian cancer. The high sensitivity of the method is similar to studies [4,5,8,11,[14][15][16][17][18][19]. Superiority of the PET/CT over conventional imaging methods, like US, CT and MRI was demonstrated in the literature [9,[18][19][20].…”

“…The presence of postoperative anatomical alterations in the abdominal cavity reduces specificity of the MRI in detecting recurrence [4,24]. In the PET/CT these anatomical conditions are less important for the diagnosis [11,15,16], but non-specific nature of the [18F]FDG tracer uptake, which accumulates at any site with increased glucose metabolism, e.g. areas of inflammation and infection or in muscles on contraction, is however a limitation of the method and like in our study can cause false positive results [6,25].…”

“…The high incidence of both peritoneal implants and retroperitoneal lymph nodes involvement in recurrent serous ovarian cancer was confirmed in our study. According to the data from the literature, the sensitivity and the specificity of the PET/CT in detecting peritoneal implants in recurrent ovarian cancer are very high [8,15,16,27]. Rubini et al [14] described an advantage of the PET/CT over another imaging methods in this indication (85% sensitivity and 92.3% specificity) [14,18].…”

The value of [18F]FDG PET/CT examination in the detection and differentiation of recurrent ovarian cancer

“…According to the literature, mucinous and clear-cell ovarian cancers represent a potential source of [ 18 F]FDG PET-negative findings [20]. The high sensitivity of the method is similar to studies conducted by other authors [4,8,9,14,18,19,[21][22][23][24]. Risum et al [21] reported that sensitivity and speci ficity in the detection of relapse of ovarian cancer are 66% and 90% for the US and 81% and 90% for CT [21].…”

“…According to literature data, the sensitivity and specificity of [ 18 F]FDG PET/CT in detecting peritoneal implants of recurrent ovarian cancer are very high [3,8,19,23]. Rubini et al [9] described an advantage of [ 18 F]FDG PET/CT over other imaging methods (85% sensitivity and 92.31% specificity).…”