Thin-section CT follow-up of metastatic ovarian carcinoma correlation with levels of CA-125 marker and clinical history

Francesco Ferrozzi, Davide Bova, Flavia De Chiara, Giacomo Garlaschi, Ferdinando Draghi, Giovanni Cocconi, Pellegrino Bassi

Research output: Contribution to journalArticle

Abstract

Second-look laparotomy and CA-125 are the gold standard in follow-up of ovarian carcinoma. Since no definite role seems established for cross-sectional imaging in assessment of recurrence we employed thin-section computed tomography (CT), correlated with CA-125 levels and detailed knowledge of the clinical history as a follow-up protocol. One hundred seventy-seven patients with ovarian carcinoma were selected because of: (a) pathologically proven remission after first-line chemotherapy, (b) follow-up by means of thin-section CT every 6 months for the first 3 years and every 10 months subsequently, (c) monitoring CA-125 serum levels every 3 months for the first 3 years and every 6 months subsequently; (d) pathologic confirmation or clinical and laboratory follow-up after 12 months or longer from the CT findings. Fifty percent of the patients showed recurrence of disease. Our protocol yielded 93.2% true positive, dubious findings in 5.6%, 1.0% false negatives, 97.7% true negatives, and 2.3% false positive. With a tailored technique, CT was particularly sensitive in early diagnosis of peritoneal seeding, even in the absence of ascites or increases in the levels of CA-125. Repeated administration of contrast medium, water enemas, and repeated scanning of suspicious volumes with differing scanning parameters were the factors managed by the radiologist. We conclude that thin-section CT, correlated with CA-125 levels and careful review of the clinical history could represent a valid alternative to repeated explorative laparotomies in the follow-up of ovarian carcinomas.

Original languageEnglish
Pages (from-to)364-370
Number of pages7
JournalClinical Imaging
Volume22
Issue number5
DOIs
Publication statusPublished - Sep 1998

Keywords

  • Metastases
  • Neoplasms
  • Ovary
  • Peritoneum
  • Staging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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