Whole-body PET with (fluorine-18)-2-deoxyglucose for detecting recurrent primary serous peritoneal carcinoma: An initial report.
OBJECTIVE
Because of the limited sensitivity and specificity of conventional tools such as computerized tomography (CT) or magnetic resonance imaging (MRI) for detecting persistent or recurrent primary serous peritoneal carcinoma (PSPC), a reliable means of diagnosis remains elusive. Positron emission tomography (PET) scanning may offer another approach to this problem.


METHODS
A prospective study of three patients requiring surgical exploration for suspected recurrence of PSPC received a whole-body PET (fluorine-18)-2-deoxyglucose (FDG) scanning in a teaching hospital from July 1995 to December 1998. The suspected recurrence was based upon clinical findings including a detailed physical examination, serum CA-125 marker ultrasound, CT, and MRI. Three patients were enrolled in this study.


RESULTS
In all three patients, PET images demonstrated increased FDG uptake in a distribution that correlated with surgical-pathologic findings (100%); on the contrary, CT can detect 33.3% of these patients with malignant diseases and MRI can detect two-thirds of cases. Serum CA-125 was also elevated in all three patients, although one patient showed an equivocal elevation of 25.7 IU/ml.


CONCLUSIONS
Conventional imaging studies are neither sensitive nor specific for detecting recurrent PSPC. In contrast, besides CA-125, PET might offer a relatively effective tool for detecting recurrent primary serous peritoneal carcinoma. Due to the very small number of patients available in this study, considerable research must be performed to clarify the impact of PET on detecting recurrence of PSPC.
Wang
P H
PH
Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, 112, Taiwan. phwang@vghtpe.gov.tw
Liu
R S
RS
Li
Y F
YF
Ng
H T
HT
Yuan
C C
CC
D000328:Adult; D018394:CA-125 Antigen / Q000097:blood; D018283:Cystadenocarcinoma, Papillary / Q000097:blood / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008279:Magnetic Resonance Imaging; D009364:Neoplasm Recurrence, Local; D010534:Peritoneal Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000473:pathology; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed
D018394:CA-125 Antigen; D019788:Fluorodeoxyglucose F18