Role of 18F-FDG PET/CT in diagnosing peritoneal carcinomatosis in the restaging of patient with ovarian cancer as compared to contrast enhanced CT and tumor marker Ca-125

Rev Esp Med Nucl Imagen Mol. 2014 Jan-Feb;33(1):22-7. doi: 10.1016/j.remn.2013.06.008. Epub 2013 Aug 13.

Abstract

Objectives: To investigate the role of whole-body fluorine-18-2-deoxy-2-fluoro-d-glucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) in the identification of peritoneal carcinomatosis in patients with ovarian cancer (OC).

Material and methods: Seventy-nine patients with histologically proven stages III-IV OC who underwent (18)F-FDG PET/CT were studied retrospectively. We considered group A as 51 patients who also underwent computed-tomography with contrast-enhancement (CECT), and group B as 35 patients who had also been tested for biomarker Ca-125. Sensitivity, specificity, accuracy, positive predictive values (PPV) and negative predictive values (NPV) of (18)F-FDG PET/CT as compared to CECT and to Ca-125 were evaluated.

Results: (18)F-FDG PET/CT' sensitivity, specificity, accuracy, PPV and NPV for all 79 patients were: 85%, 92.31%, 88.61%, 91.89% and 85.71%, respectively. (18)F-FDG PET/CT sensitivity in group A was 78.6%, while it was 53.6% for CECT. (18)F-FDG PET/CT specificity, calculated in the same group, was 91.3%, while that of CECT was 60.9% (statistically significant difference, McNemar 4, P=0.039). Accuracy was 84.3% and 56.9%, respectively. (18)F-FDG PET/CT' sensitivity in group B was 86.4%, while that of Ca-125 was 81.8% (no statistical difference, McNemar 0, P=1). (18)F-FDG PET/CT specificity in group B was 84.6% while that of Ca-125 was 38.5% (clear but not statistically significant difference, McNemar 3.12, P=0.070). Accuracy calculated in the same group was 85.7% for (18)F-FDG PET/CT and 65.7% for Ca-125.

Conclusion: (18)F-FDG PET/CT is a useful diagnostic tool when peritoneal biopsy cannot be performed and it can better select those who are candidates for adjuvant chemotherapy.

Keywords: (18)F-FDG PET/CT; CT contraste; Ca-125; Contrast enhanced CT; Cáncer de ovario; Metástasis peritoneales; Ovarian cancer; Peritoneal metastases.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • CA-125 Antigen / blood*
  • Carcinoma / diagnosis
  • Carcinoma / secondary*
  • Carcinoma / surgery
  • Contrast Media
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Hysterectomy
  • Membrane Proteins / blood*
  • Middle Aged
  • Multimodal Imaging
  • Neoplasm Staging / methods*
  • Ovarian Neoplasms / blood
  • Ovarian Neoplasms / pathology*
  • Ovarian Neoplasms / surgery
  • Ovariectomy
  • Peritoneal Neoplasms / diagnosis
  • Peritoneal Neoplasms / secondary*
  • Peritoneal Neoplasms / surgery
  • Positron-Emission Tomography / methods*
  • Radiopharmaceuticals
  • Retrospective Studies
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed / methods*

Substances

  • CA-125 Antigen
  • Contrast Media
  • MUC16 protein, human
  • Membrane Proteins
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18