Ovarian cancer has the highest mortality of all gynecologic malignancies. FDG-PET/CT was proven to be accurate for identification of primary ovarian tumors, regional lymph nodes, and distant metastases.
Purpose
To evaluate ovarian masses at FDG-PET/CT in correlation with histopathologic findings.
Material and Methods
Ninety-eight patients underwent whole body FDG-PET/CT examination. Eighty-six patients with primary ovarian cancer and 12 patients with metastatic disease to the ovaries were included.
Results
PET/CT imaging was true-positive in 87/94 patients with malignant tumors. In 4/4 patients with benign tumors, PET/CT results were true-negative, with sensitivity of 92.6%, specificity 100%, total test accuracy 92.9%. Fifty-seven patients were diagnosed as stage IV ovarian cancer with distant metastasis.
Conclusion
The anatomical/functional examination by FDG-PET/CT was proven to be valuable in increasing the diagnostic accuracy that can help improve patient management.
FenchelS, GrabD, NuessleKAsymptomatic adnexal masses: Correlation of FDG PET and histopathologic findings. Radiology2002; 223: 780-8
8.
RohrenEM, TurkingtonTG, ColemanRE. Clinical applications of PET in oncology. Radiology2004; 231: 305-32
9.
YoshidaY, KurokawaT, KawaharaKIncremental benefits of FDG positron emission tomography over CT alone for the preoperative staging of ovarian cancer. Am J Roentgenol2004; 182: 227-33
10.
NishizawaS, InubushiM, OkadaH. Physiological 18F-FDG uptake in the ovaries and uterus of healthy female volunteers. Eur J Nucl Med Mol Imaging2005; 32: 549-56
11.
KitajimaK, MurakamiK, YamasakiEAccuracy of integrated FDG-PET/contrast-enhanced CT in detecting pelvic and paraaortic lymph node metastasis in patients with uterine cancer. Eur Radiol2009; 19: 1529-36
12.
ChoiHJ, RohJW, SeoSSComparison of the accuracy of magnetic resonance imaging and positron emission tomography/computed tomography in the presurgical detection of lymph node metastases in patients with uterine cervical carcinoma. Cancer2006; 106: 914-22
13.
SironiS, BudaA, PicchioMLymph node metastasis in patients with clinically early stage cervical cancer: Detection with integrated FDG PET/CT. Radiology2006; 238: 272-9
14.
LoftA, BerthelsenAK, RoedHThe diagnostic value of PET/CT scanning in patients with cervical cancer: A prospective study. Gynecol Oncol2007; 106: 29-34
15.
ParkJY, KimEN, KimDYComparison of the validity of magnetic resonance imaging and positron emission tomography/computed tomography in the preoperative evaluation of patients with uterine corpus cancer. Gynecol Oncol2008; 108: 486-92
16.
CaseyMJ, GuptaNC, MuthsCK. Experience with positron emission tomography (PET) scans in patients with ovarian cancer. Gynecol Oncol1994; 53: 331-8
17.
KarlanBY, HawkinsR, HohCWhole-body positron emission tomography with 2-[18F]-fluoro-2-deoxy-D-glucose can detect recurrent ovarian carcinoma. Gynecol Oncol1993; 51: 175-81
18.
RomerW, AvrilN, DoseJMetabolic characterization of ovarian tumors with positron-emission tomography and F-18 fluorodeoxyglucose. Rofo1997; 166: 62-8
19.
SchroderW, ZimnyM, RudlowskiCThe role of 18F-fluoro-deoxyglucose positron emission tomography (18F-FDG PET) in diagnosis of ovarian cancer. Int J Gynecol Cancer1999; 9: 117-22
20.
LiebermanG, MacLeanAB, BuscombeJRThe clinical application of a dual head gamma camera with coincidence detection in 20 women with suspected ovarian cancer. BJOG2001; 108: 1229-36
21.
SkírnisdóttirI, GarmoH, WilanderEBorderline ovarian tumors in Sweden 1960-2005: trends in incidence and age at diagnosis compared to ovarian cancer. Int J Cancer2008; 123: 1897-901
22.
RisumaS, HøgdallC, LoftAThe diagnostic value of PET/CT for primary ovarian cancer-A prospective study. Gynecologic Oncology2007; 105: 145-9
23.
KerrouK, MontraversF, GrahekDDetection of recurrence of ovarian cancer using (F-18)-FDG scan performed on a dual head coincidence gamma camera (CDET). Clin Positron Imaging2000; 3: 186
24.
GrisaruD, AlmogB, LevineCThe diagnostic accuracy of 18F-fluorodeoxyglucose PET/CT in patients with gynecological malignancies. Gynecol Oncol2004; 94: 680-4
25.
KimEE. Whole-body positron emission tomography and positron emission tomography/computed tomography in gynecologic oncology. Int J Gynecol Cancer2004; 14: 12-22
26.
BristowRE, GiuntoliRL2nd, PannuHKCombined PET/CT for detecting recurrent ovarian cancer limited to retroperitoneal lymph nodes. Gynecol Oncol2005; 99: 294-300
27.
SironiS, PicchioM, LandoniCPost-therapy surveillance of patients with uterine cancers: value of integrated FDG PET/CT in the detection of recurrence. Eur J Nucl Med Mol Imaging2007; 34: 472-9
28.
BristowRE, del CarmenMG, PannuHKClinically occult recurrent ovarian cancer: patient selection for secondary cytoreductive surgery using combined PET/CT. Gynecol Oncol200390:519-28
29.
TorizukaT, KannoT, FutatsubashiMImaging of gynecologic tumors: comparison of (11)C-choline PET with (18)F-FDG PET. J Nucl Med2003; 44: 1051-6
30.
NakamotoY, SagaT, IshimoriTClinical value of positron emission tomography with FDG for recurrent ovarian cancer. Am J Roentgenol2001; 176: 1449-54
31.
ZimnyM, SiggelkowW, SchroderW2-[Fluorine-18]-fluoro-2-deoxy-d-glucose positron emission tomography in the diagnosis of recurrent ovarian cancer. Gynecol Oncol2001; 83: 310-15
32.
YenRF, SunSS, ShenYYWhole body positron emission tomography with 18F-fluoro-2-deoxyglucose for the detection of recurrent ovarian cancer. Anticancer Res2001; 21: 3691-4
33.
ChoSM, HaHK, ByunJYUsefulness of FDG PET for assessment of early recurrent epithelial ovarian cancer. Am J Roentgenol2002; 179: 391-5
34.
ZhangH, TianM, OriuchiNOncological diagnosis using positron coincidence gamma camera with fluorodeoxyglucose in comparison with dedicated PET. Br J Radiol2002; 75: 409-16
