The impact of PET/CT in the management of recurrent ovarian cancer.
OBJECTIVE
To evaluate the impact of PET/CT on the restaging and management of recurrent ovarian cancer.


METHODS
From January 2002 to July 2003, all women undergoing either surveillance or investigation of possible recurrent ovarian cancer at the Centre for Molecular Imaging, The Peter MacCallum Cancer Centre, were invited to take part in a prospective evaluation of the clinical impact of PET/CT.


RESULTS
Fifty-six women having 66 scans were available for analysis. All patients had at least 12months follow-up after the PET/CT unless they died before that time. Apart from one equivocal scan, all scans performed in women with a CA125 higher than 35IU/ml had a positive PET/CT. PET/CT altered the known disease distribution in 40 scans (64%). Overall, PET/CT showed less disease in six scans (9%) and more disease in 34 scans (52%). Regardless of the value of CA125, PET/CT identified a sub group of women with apparently localized disease or no definite evidence of disease. This group showed improved survival compared with women shown to have systemic disease. PET/CT resulted in a major change of management plan in 34 patients (58%).


CONCLUSIONS
PET/CT modifies the assessment of the distribution of recurrent ovarian cancer and alters patient management in a substantial proportion of patients. PET/CT appears to offer prognostic information.
Simcock
Bryony
B
Gynaecology-Oncology Unit, The Peter MacCallum Cancer Centre, 12 Cathedral Place, East Melbourne VIC 3002, Australia.
Neesham
Deborah
D
Quinn
Michael
M
Drummond
Elisabeth
E
Milner
Alvin
A
Hicks
Rodney J
RJ
D018394:CA-125 Antigen / Q000097:blood; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed
D018394:CA-125 Antigen