PET/CT in the staging of patients with a pelvic mass suspicious for ovarian cancer

Gynecol Oncol. 2013 Dec;131(3):694-700. doi: 10.1016/j.ygyno.2013.08.020. Epub 2013 Aug 27.

Abstract

Objective: To prospectively assess the value of PET/CT for staging, diagnosis and operability of ovarian cancer, with special attention to the peritoneal spread.

Methods: From June 2009 to March 2011, 69 patients with suspicion of having an ovarian cancer underwent an (18)F-FDG PET/CT. To identify the diagnostic value of PET/CT, the results were compared with the findings at diagnostic laparoscopy and/or debulking surgery.

Results: There were 56 patients with malignant tumors and 13 with benign tumors. We observed a sensitivity and specificity of 93% and 77%, respectively for malignant tumors with PET/CT. CT alone had a sensitivity and specificity of 96% and 38%, respectively. The overall FIGO classification evaluation for PET/CT and CT were the same. For the evaluation of metastases, the sensitivity of PET/CT was worse, while the specificity was better than CT. Retroperitoneal lymph node metastases were diagnosed better with PET/CT, while there was no difference for peritoneal spread and for the intestines. PET/CT detected another unknown primary tumor in 3 (4.3%) cases.

Conclusion: PET/CT is better than CT in detecting retroperitoneal lymph node metastases, but not for peritoneal metastases.

Keywords: (18)F-FDG PET/CT; Diagnosis; Operability; Ovarian cancer; Staging.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Lymph Nodes / diagnostic imaging
  • Lymph Nodes / pathology
  • Lymphatic Metastasis
  • Middle Aged
  • Multimodal Imaging / methods
  • Neoplasm Metastasis
  • Neoplasm Staging
  • Ovarian Neoplasms / diagnostic imaging*
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / surgery
  • Positron-Emission Tomography
  • Prospective Studies
  • Radiopharmaceuticals*
  • Tomography, X-Ray Computed
  • Ultrasonography
  • Young Adult

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18