Investigation of 18F-FDG PET/CT Findings and CA-125 Levels in Ovarian Cancer Staging

Investigation of 18F-FDG PET/CT Findings and CA-125 Levels in Ovarian Cancer Staging

OBJECTIVE This study aims are to investigate the role of 18F labeled fluoro-2-deoxy-D-glucose positron emission computed tomography/computed tomography (18F FDG PET/CT) in the initial staging and recurrence detection of ovarian cancer and to compare it with the cancer antigen-125 (CA-125) value. METHODS A total of 93 patients with a primary ovarian cancer diagnosis (Group 1 n=41) or suspicion of recurrent ovarian cancer (Group 2 n=52) were included in this study from January 2007 to January 2013. RESULTS The ages of the patients were between 15 and 82 years. In cases with PET positive lesions (n=84); Ovar- ian lesion (n=34), infradiaphragmatic lymph node metastasis (n=46), supradiaphragmatic lymph node metastasis (n=14), peritoneal implant (n=67), and distant metastasis (n=14) were detected. Histopatho- logical examination of 4 PET positive ovarian lesions was not compatible with cancer. In 14 cases with low CA-125 value, 18F FDG PET/CT was able to detect primary/recurrent lesions accurately. In the evaluation of primary/recurrent ovarian cancer, 18F FDG PET/CT had 93% sensitivity, 42.8% specific- ity, 89.2% accuracy, whereas CA-125 had 79.1% sensitivity, 42.8% specificity, and 76.3% accuracy. CONCLUSION In conclusion; even in low CA-125 values, 18F FDG PET/CT is a prominent method that can detect especially extra-abdominal distant metastatic foci in the initial staging of primary ovarian cancer and diagnosis and follow-up of recurrent ovarian cancer.

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  • 1. Rooth C. Ovarian cancer: risk factors, treatment and management. Br J Nurs 2013;22(17):23–30.
  • 2. Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA Cancer J Clin 2014;64(1):9–29.
  • 3. Marcus C, Maxwell GL, Darcy KM, Hamilton CA, McGuire WP. Current approaches and challenges in managing and monitoring treatment response in ovar- ian cancer. J Cancer 2014;5(1):25–30.
  • 4. Cass I, Baldwin RL, Varkey T, Moslehi R, Narod SA, Karlan BY. Improved survival in women with BRCA-associated ovarian carcinoma. Cancer 2003;97(9):2187–95.
  • 5. Le T, Krepart GV, Lotocki RJ, Heywood MS. Does debulking surgery improve survival in biologi- cally aggressive ovarian carcinoma. Gynecol Oncol 1997;67(2):208–14.
  • 6. Oliphant M, Berne AS, Meyers MA. Bidirectional spread of disease via the subperitoneal space: the lower abdomen and left pelvis. Abdom Imaging. 1993;18(2):117–25.
  • 7. von Georgi R, Schubert K, Grant P, Münstedt K. Post- therapy surveillance and after-care in ovarian cancer. Eur J Obstet Gynecol Reprod Biol 2004;114(2):228–33.
  • 8. Johanna H, Auranen A, Carpén O, Dean K, Seppänen M, Kemppainen J, et al. FDG PET/CT in staging of ad- vanced epithelial ovarian cancer: Frequency of supra- diaphragmatic lymph node metastasis challenges the traditional pattern of disease spread. Gynecol Oncol 2012;126(1):64–8.
  • 9. Chang WC, Hung YC, Kao CH, Yen RF, Shen YY, Lin CC. Usefulness of whole body positron emission to- mography (PET) with 18F-fluoro-2-deoxyglucose (FDG) to detect recurrent ovarian cancer based on asymptomatically elevated serum levels of tumor marker. Neoplasma 2002;49(5):329–33.
  • 10. Berek JS. Ovarian cancer. Novaks Gynecology. 13th ed. Philadelphia: Lippincott Williams & Wilkins; 2002. p. 1245–318.
  • 11. Palomar A, Nani C, Castellucci P, Ambrosini V, Mon- tini CG, Allegri V, et al. Value of FDG PET/CT in pa- tients with treated ovarian cancer and raised CA125 serum levels. Mol Imaging Biol 2012;14(1):123–9.
  • 12. Prayer L, Kainz C, Kramer J, Stiglbauer R, Schurawitzki H, Baldt M, et al. CT and MR accuracy in the dedec- tion of tumor recurrence in pations treated for ovarian cancer. J Comput Asist Tomogr 1993;17(4):626–32.
  • 13. Bristow RE, Marcela GC, Pannu HK, Cohade C, Zahu- rak ML, Fishman EK, et al. Clinically occult recurrent ovarian cancer: patient selection for secondary cytore- ductive surgery using combined PET/CT. Gynecol Oncol 2003;90(3):519–28.
  • 14. Hauth EA, Antoch G, Stattaus J, Kuehl H, Veit P, Bock- isch A, et al. Evaluation of integrated whole-body PET/CT in the detection of recurrent ovarian cancer. Eur J of Radiol 2005;56(2):263–8.
  • 15. DeRosa V, Mangoni di SML, Brunetti A, Caraco C, Graziano R, Gallo MS, et al. Computed tomography and secondlook surgery in ovarian cancer patients. Correlation, actual role and limitations of CT scan. Eur J Gynaecol Oncol 1995;16(2):123–9.
  • 16. Makhija S, Howden N, Edwards R, Kelley J, Townsend DW, Meltzer CC. Positron emission tomography/ computed tomography imaging for the detection of recurrent ovarian and fallopian tube carcinoma: a ret- rospective review. Gynecol Oncol 2002;85(1):53–8.
  • 17. Musto A, Rampin L, Nanni C, Marzola MC, Fanti S, Rubello D. Present and future of PET and PET/ CT in gynaecologic malignancies. Eur J Radiol 2011;78(1):12–20.
  • 18. Thrall MM, DeLoia JA, Gallion H, Avril N. Clinical use of combined positron emission tomography and computed tomography (FDG-PET/CT) in recurrent ovarian cancer 2007;105(1):17–22.
  • 19. Chung HH, Kang WJ, Kim WJ, Park NH, Song YS, Chung JK, et al. Role of [18F] FDG PET/CT in the as- sessment of suspected recurrent ovarian cancer: corre- lation with clinical or histological findings. Eur J Nucl Med Mol Imaging 2007;34(4):480–6.
  • 20. Son H, Khan SM, Rahaman J, Cameron KL, Prasad- Hayes M, Chuang L, et al. Role of FDG PET/CT in staging of recurrent ovarian cancer. Radio Graphics 2011;31(2):569–83.
  • 21. Tanizaki Y, Kobayashi A, Shiro M, Ota N, Takano R, Mabuchi Y, et al. Diagnostic value of preoperative SUVmax on FDG-PET/CT for the detection of ovar- ian cancer. Int J Gynecol Cancer 2014;24(3):454–60.
Türk Onkoloji Dergisi-Cover
  • ISSN: 1300-7467
  • Başlangıç: 2015
  • Yayıncı: Ali Cangül
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