Role of [18F]FDG PET/CT in the assessment of suspected recurrent ovarian cancer:: correlation with clinical or histological findings

被引:76
作者
Chung, Hyun Hoon
Kang, Won Jun
Kim, Jae Weon
Park, Noh-Hyun
Song, Yong-Sang
Chung, June-Key
Kang, Soon-Beom
Lee, Hyo-Pyo
机构
[1] Seoul Natl Univ, Coll Med, Dept Obstet & Gynecol, Seoul 110744, South Korea
[2] Seoul Natl Univ, Coll Med, Dept Nucl Med, Seoul, South Korea
关键词
PET/CT; recurrence; ovarian cancer; accuracy; impact;
D O I
10.1007/s00259-006-0260-x
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Purpose To evaluate the accuracy of integrated positron emission tomography (PET) and computed tomography (CT) for depiction of suspected recurrent ovarian carcinoma after treatment, with use of clinical or histological findings as the reference standard. Methods Seventy-seven women (median age, 51 years) with ovarian carcinoma treated with primary cytoreductive surgery followed by platinum-based combination chemotherapy were included, and [F-18]fluorodeoxyglucose (FDG) PET/CT was performed for suspected recurrence. In all patients, imaging findings were compared with results of histological examination after surgical exploration or clinical follow-up to determine the diagnostic accuracy of PET/CT in the evaluation of disease status. Fisher's exact test was used to measure the ability of PET/CT to predict recurrent lesions. Results Forty-five (58.4%) of the 77 patients had documented recurrence during surgical exploration or clinical follow-up, while 32 (41.6%) had no evidence of recurrent tumour. Of the 45 patients with recurrent disease, 27 (60%) were confirmed to have recurrence by surgical biopsy. A correlation was found between PET/CT and histological or clinical analyses (kappa = 0.894). The overall sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PET/CT were 93.3%, 96.9%, 94.8%, 97.7% and 91.2%, respectively. PET/CT modified the diagnostic or treatment plan in 19 (24.7%) patients, by leading to the use of previously unplanned therapeutic procedures in 11 (57.9%) patients and the avoidance of previously planned diagnostic procedures in eight (42.1%) patients. Conclusion Integrated FDG PET/CT is a sensitive post-therapy surveillance modality for the detection of recurrent ovarian cancer; it aids decisions on treatment plans and may ultimately have a favourable impact on prognosis.
引用
收藏
页码:480 / 486
页数:7
相关论文
共 36 条
[1]  
AMENDOLA MA, 1985, CRC CR REV DIAGN IM, V24, P329
[2]   Dual-modality PET/CT scanning with negative oral contrast agent to avoid artifacts: Introduction and evaluation [J].
Antoch, G ;
Kuehl, H ;
Kanja, J ;
Lauenstein, TC ;
Schneemann, H ;
Hauth, E ;
Jentzen, W ;
Beyer, T ;
Goehde, SC ;
Debatin, JF .
RADIOLOGY, 2004, 230 (03) :879-885
[3]  
Bristow RE, 2000, CANCER, V89, P1532, DOI 10.1002/1097-0142(20001001)89:7<1532::AID-CNCR17>3.0.CO
[4]  
2-A
[5]   Clinically occult recurrent ovarian cancer: patient selection for secondary cytoreductive surgery using combined PET/CT [J].
Bristow, RE ;
del Carmen, MG ;
Pannu, HK ;
Cohade, C ;
Zahurak, ML ;
Fishman, EK ;
Wahl, RL ;
Montz, FJ .
GYNECOLOGIC ONCOLOGY, 2003, 90 (03) :519-528
[6]   Positron emission tomography for detecting clinically occult surgically resectable metastatic ovarian cancer [J].
Bristow, RE ;
Simpkins, F ;
Pannu, HK ;
Fishman, EK ;
Montz, FJ .
GYNECOLOGIC ONCOLOGY, 2002, 85 (01) :196-200
[7]   PET attenuation coefficients from CT images: experimental evaluation of the transformation of CT into PET 511-keV attenuation coefficients [J].
Burger, C ;
Goerres, G ;
Schoenes, S ;
Buck, A ;
Lonn, AHR ;
von Schulthess, GK .
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2002, 29 (07) :922-927
[8]  
Chang WC, 2002, NEOPLASMA, V49, P329
[9]   Image analysis in patients with cancer studied with a combined PET and CT scanner [J].
Charron, M ;
Beyer, T ;
Bohnen, NN ;
Kinahan, PE ;
Dachille, M ;
Jerin, J ;
Nutt, R ;
Meltzer, CC ;
Villemagne, V ;
Townsend, DW .
CLINICAL NUCLEAR MEDICINE, 2000, 25 (11) :905-910
[10]   Peritoneal metastases: Detection with spiral CT in patients with ovarian cancer [J].
Coakley, FV ;
Choi, PH ;
Gougoutas, CA ;
Pothuri, B ;
Venkatraman, E ;
Chi, D ;
Bergman, A ;
Hricak, H .
RADIOLOGY, 2002, 223 (02) :495-499