Revisiting the clinical value of 18F-FDG PET/CT in detection of recurrent epithelial ovarian carcinomas: Correlation with histology, serum CA-125 assay, and conventional radiological modalities

Lidija Antunovic, Marino Cimitan, Eugenio Borsatti, Tanja Baresic, Roberto Sorio, Giorgio Giorda, Agostino Steffan, Luca Balestreri, Rosa Tatta, Giovanna Pepe, Domenico Rubello, Diego Cecchin, Vincenzo Canzonieri

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: This study aimed to evaluate the efficiency of F-FDG PET/CT in suspected recurrence of epithelial ovarian cancer, after treatment, comparing outcomes of PET/CT with histological tumor subtype, CA-125 serum levels, and findings of conventional diagnostic imaging modalities (CI). METHODS: Data from 121 women who underwent FDG PET/CT for suspected recurrence of epithelial ovarian cancer after treatment were reviewed retrospectively. RESULTS: Of all patients, 80% had recurrent disease and 20% were disease-free on the final clinical diagnosis. PET/CT showed true-positive findings in 82% of patients, whereas CI demonstrated true-positives in 70% of cases. At the time of PET/CT scanning, only 55 patients had serum CA-125 level greater than 35 U/mL, whereas 52 patients presented with CA-125 levels in a reference range. PET/CT sensitivity (82%) was significantly higher than that of CA-125 (59%), whereas difference in sensitivity between PET/CT and CI (69%) was limited. PET/CT specificity (87%) was significantly better than that of CI (47%), although no difference in specificity between PET/CT and CA-125 (80%) was found. However, no difference in CA-125 serum levels between patients with local tumor relapse and those with distant metastases was found. PET/CT showed the highest positive predictive value (96%) and negative predictive value (55%) when compared with other modalities. In high-grade tumors (n = 66), PET/CT accuracy was 80%, better than that of serum CA-125 (64%) and that of CI (62%). Equally in low-grade ovarian carcinomas (n = 55), PET/CT accuracy (87%) was significantly higher than that of the tumor marker (60%) and also higher than that of CI (70%). CONCLUSIONS: FDG PET/CT was proven to be more efficient than serum CA-125 assay and CI in detecting recurrences of ovarian cancer after treatment. The sensitivity of FDG PET/CT is not influenced by tumor histology. FDG PET/CT should be considered a useful diagnostic tool in the surveillance of patients that received treatment for epithelial ovarian carcinoma.

Original languageEnglish
JournalClinical Nuclear Medicine
Volume37
Issue number8
DOIs
Publication statusPublished - Aug 2012

Keywords

  • F-FDG PET/CT
  • CA-125
  • conventional imaging
  • disease recurrence
  • epithelial ovarian carcinoma

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Fingerprint Dive into the research topics of 'Revisiting the clinical value of 18F-FDG PET/CT in detection of recurrent epithelial ovarian carcinomas: Correlation with histology, serum CA-125 assay, and conventional radiological modalities'. Together they form a unique fingerprint.

Cite this