The clinical application of a dual head gamma camera with coincidence detection in 20 women with suspected ovarian cancer.
OBJECTIVE
To assess the effectiveness of a dual head coincidence gamma camera in identifying ovarian cancer as a less expensive alternative to the traditional 2-[18F] fluoro-2-deoxy-D-glucose (18FDG) system using positron emission tomography.


METHODS
Prospective study.


METHODS
Twenty consecutive women suspected of having ovarian carcinoma. Inclusion was based on abnormal serum CA125 (reference range is 0-35 units/L), ultrasound, computerised tomography or clinical findings.


METHODS
Women underwent assessment before staging laparotomy. Two nuclear medicine physicians, who were blinded to the pre-operative assessment, reported on 18FDG- dual head coincidence gamma camera imaging.


METHODS
The histology and operative staging were compared with the 18FDG- dual head coincidence gamma camera findings.


RESULTS
Twelve women had pelvic malignancies (nine primary and three recurrences), seven women had benign pathology and one patient had a borderline malignancy. We were able to image accurately all malignant pelvic masses with dual head coincidence gamma camera, as well as accurately demonstrate disease spread. Two of the benign pelvic masses localised 18FDG. The positive predictive value for detecting malignancy was 86%.


CONCLUSIONS
Dual head coincidence gamma camera offers accurate and affordable imaging in suspected ovarian masses, with improved specificity over CA125, ultrasound and computerised tomography. These results are similar to those obtained on more expensive dedicated PET systems. We report on a series of patients believed to have primary or recurrent carcinoma and recognise the need to include patients more likely to have benign lesions to assess false positive results. However, we believe that dual head coincidence gamma camera is useful in the pre-operative assessment of women with suspected ovarian cancer.
Lieberman
G
G
University Department of Obstetrics and Gynaecology, Royal Free and University College Medical School, London, UK.
MacLean
A B
AB
Buscombe
J R
JR
Hilson
A J
AJ
Adamson
K
K
Reid
W M
WM
Green
A
A
Begent
R H
RH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018394:CA-125 Antigen / Q000097:blood; D005260:Female; D019788:Fluorodeoxyglucose F18; D015902:Gamma Cameras / Q000592:standards*; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity
D018394:CA-125 Antigen; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18