Thin-section CT follow-up of metastatic ovarian carcinoma correlation with levels of CA-125 marker and clinical history.
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 fist 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 for 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 negative, 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.
Instituto di Scienze Radiologicle, Università Degli Studi, Viale Gramsci, Parma, Italy.
F
F
Ferrozzi
D
D
Bova
F
F
De Chiara
G
G
Garlaschi
F
F
Draghi
G
G
Cocconi
P
P
Bassi
D000328:Adult; D018394:CA-125 Antigen / Q000097:blood*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000517:prevention & control; D011237:Predictive Value of Tests; D014057:Tomography, X-Ray Computed
D018394:CA-125 Antigen