Negative 18F-2-fluorodeoxyglucose PET/CT predicts good cancer specific survival in patients with a suspicion of recurrent ovarian cancer

Eur J Radiol. 2014 Mar;83(3):463-7. doi: 10.1016/j.ejrad.2013.12.006. Epub 2013 Dec 12.

Abstract

Aim: The aim of the present study was to investigate the diagnostic and prognostic value of combined (18)F-2-fluorodeoxyglucose positron emission tomography and contrast enhanced X-ray computed tomography (FDG-PET/CT) in women with a suspicion of recurrent ovarian cancer.

Patients and methods: We retrospectively reviewed 48 patients with a suspicion of recurrent ovarian cancer who were referred to our department for combined FDG-PET/CT.

Results: Median follow-up was 25 months. 38/48 (79%) patients showed pathological findings on PET/CT. 17/48 (35%) of patients died of ovarian cancer. One FDG-PET/CT was false positive and one was false negative, leading to a sensitivity and positive predictive value of 97% and a specificity and negative predictive value of 90%. 33/48 (69%) underwent a change in therapy following FDG-PET/CT. There was a significantly better survival in FDG-PET/CT negative than in positive patients (p=0.04). In the FDG-PET/CT negative group no patients had died of ovarian cancer during follow-up. Remarkably, there was no difference in survival between patients who only had peritoneal metastases on FDG-PET/CT and those who also had extraperitoneal metastases (p=0.71).

Conclusion: A negative FDG-PET/CT has a high negative predictive value for the presence of disease and, more importantly, is associated with a very good disease-specific survival rate.

Keywords: FDG-PET/CT; Ovarian cancer; Prognosis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Fluorodeoxyglucose F18*
  • Germany / epidemiology
  • Humans
  • Middle Aged
  • Multimodal Imaging / statistics & numerical data
  • Neoplasm Recurrence, Local / diagnosis
  • Neoplasm Recurrence, Local / mortality*
  • Neoplasm Recurrence, Local / prevention & control
  • Ovarian Neoplasms / diagnosis*
  • Ovarian Neoplasms / drug therapy
  • Ovarian Neoplasms / mortality*
  • Positron-Emission Tomography / statistics & numerical data*
  • Prevalence
  • Prognosis
  • Radiopharmaceuticals
  • Reproducibility of Results
  • Retrospective Studies
  • Risk Assessment
  • Sensitivity and Specificity
  • Survival Rate
  • Tomography, X-Ray Computed / statistics & numerical data*
  • Treatment Outcome

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18