Integrated PET/CT as a first-line re-staging modality in patients with suspected recurrence of ovarian cancer.
OBJECTIVE
The aims of this study were to compare CT with PET/CT results in patients with suspected ovarian cancer recurrence and to assess the impact of the PET/CT findings on their clinical management.


METHODS
Thirty-two consecutive patients with suspected ovarian cancer recurrence were retrospectively included in the study. Abdominal contrast-enhanced CT and PET/CT with [(18)F]FDG, in addition to conventional follow-up, were performed in all 32 patients. After the comparison between CT and PET/CT results, based on clinical reports, changes in the clinical management of patients (intermodality changes) due to PET/CT information were analysed.


RESULTS
Twenty of the 32 patients were positive at CT (62.5%) versus 29 (90.6%) at PET/CT. Intermodality changes in management, i.e. use of a different treatment modality, after PET/CT examination were indicated in 14/32 (44%) patients. In particular, before PET/CT study, the planned management was as follows: wait-and-see in 7/32 (22%), further instrumental examinations in 4/32 (12%), chemotherapy in 10/32 (31%), diagnostic surgical treatment in 6/32 (19%) and surgical treatment in the remaining 5/32 (16%). After PET/CT study, wait-and-see was indicated in 1/32 (3%), further instrumental examinations in 7/32 (22%), chemotherapy in 16/32 (50%), diagnostic surgical treatment in 2/32 (6%) and surgical treatment in the remaining 6/32 (19%).


CONCLUSIONS
Integrated PET/CT could detect tumour relapse in a higher percentage of patients than could CT. A change in the clinical management was observed in 44% of cases when PET/CT information was added to conventional follow-up findings.
Mangili
G
G
Department of Gynaecology and Obstetrics, Scientific Institute San Raffaele, Milan, Italy.
Picchio
M
M
Department of Nuclear Medicine, Scientific Institute San Raffaele, Via Olgettina 60, 20132, Milan, Italy.
Sironi
S
S
University of Milano-Bicocca, Milan, Italy.|Department of Diagnostic Radiology, San Gerardo Hospital, Monza, Italy.
Viganò
R
R
Department of Gynaecology and Obstetrics, Scientific Institute San Raffaele, Milan, Italy.
Rabaiotti
E
E
Department of Gynaecology and Obstetrics, Scientific Institute San Raffaele, Milan, Italy.
Bornaghi
D
D
Department of Gynaecology and Obstetrics, Scientific Institute San Raffaele, Milan, Italy.
Bettinardi
V
V
Department of Nuclear Medicine, Scientific Institute San Raffaele, Via Olgettina 60, 20132, Milan, Italy.
Crivellaro
C
C
University of Milano-Bicocca, Milan, Italy.
Messa
C
C
University of Milano-Bicocca, Milan, Italy.|Department of Nuclear Medicine, San Gerardo Hospital, Monza, Italy.|IBFM-CNR, Milan, Italy.
Fazio
F
F
Department of Nuclear Medicine, Scientific Institute San Raffaele, Via Olgettina 60, 20132, Milan, Italy. fazio.ferruccio@hsr.it.|University of Milano-Bicocca, Milan, Italy. fazio.ferruccio@hsr.it.|IBFM-CNR, Milan, Italy. fazio.ferruccio@hsr.it.
D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000473:pathology; D009367:Neoplasm Staging / Q000379:methods; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000473:pathology*; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18