Diagnostic accuracy of FDG PET in the follow-up of platinum-sensitive epithelial ovarian carcinoma.
OBJECTIVE
This study was designed to retrospectively evaluate the diagnostic yield of FDG PET for the diagnosis of recurrent ovarian cancer.


METHODS
Eighty FDG PET scans were performed on 55 patients owing to suspicion of relapse, and 45 FDG PET scans were performed on 31 patients who were clinically disease free. PET results were compared with the results of conventional radiological imaging (CIM) and serum CA 125 levels, and related to pathological findings in 54 cases or clinical follow-up in 71 cases.


RESULTS
CIM correctly identified 49 cases with recurrence [sensitivity (SE) 53.3%] ,and there were 27 true negatives [specificity (SP) 81.8%] However, 43 cases were false negative and six were false positive. The positive predictive value (PPV), negative predictive value (NPV) and accuracy (ACC) of CIM were 89%, 38.6% and 60.8%, respectively. FDG PET correctly detected recurrent disease in 80/92 cases (SE 86.9%, p<0.05) and ruled out relapse in 26/33 cases (SP=78.8%). The PPV, NPV and ACC of PET were 91.9%, 68.4% and 84.8%, respectively. Standardised uptake values did not provide additional diagnostic accuracy compared with visual analysis. The CA 125 results showed an SE of 57.6%, an SP of 93.9% and an ACC of 67.2%. In 23 patients with positive serum CA 125 levels, but negative CIM, FDG PET was positive and relapse was confirmed. Furthermore, FDG PET was positive and relapse was confirmed in 11 patients with negative serum CA 125 levels and CIM.


CONCLUSIONS
FDG PET may detect recurrent ovarian cancer earlier than CIM, with higher sensitivity and even higher diagnostic accuracy.
García-Velloso
María José
MJ
Department of Nuclear Medicine, Clínica Universitaria, Facultad de Medicina, Universidad de Navarra, Avda. Pío XII, 36, 31008, Pamplona, Spain. mjgarciave@unav.es
Jurado
Matías
M
Ceamanos
Carolina
C
Aramendía
José Manuel
JM
Garrastachu
María Puy
MP
López-García
Guillermo
G
Richter
José Angel
JA
D000328:Adult; D000970:Antineoplastic Agents / Q000494:pharmacology*; D018394:CA-125 Antigen / Q000097:blood; D002945:Cisplatin / Q000494:pharmacology*; D005189:False Positive Reactions; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000494:pharmacology*; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D049268:Positron-Emission Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D012008:Recurrence; D015203:Reproducibility of Results; D051598:Whole Body Imaging
D000970:Antineoplastic Agents; D018394:CA-125 Antigen; D019788:Fluorodeoxyglucose F18; D002945:Cisplatin