title: PET-CT vs. CT alone in ovarian cancer recurrence.
abstract: BACKGROUND
  To compare fusion, positron emission tomography-computed tomography (PET-CT) with CT alone in detecting ovarian carcinoma recurrence.
  
  
  METHODS
  Fifty-one consecutive patients underwent 53 restaging PET-CT scans with a concurrent diagnostic quality CT scan. Two body imaging radiologists independently assessed the CT's; each then teamed with a nuclear medicine specialist to review the PET-CT's. Two teams conferred for consensus on the presence of disease in the chest, abdomen, and body overall with CT alone and with PET-CT, using a six-point reader confidence metric to determine accuracy and receiver operating characteristic (ROC) curves. Reader agreement was compared using kappa. Recurrence was determined by two gynecologic oncologists reviewing clinical records from time of presentation to at least 13 months (mean 22.7) after imaging.
  
  
  RESULTS
  Recurrence was based on histopathology in 17% (9/53). Seventy-two percent (38/53) cases had recurrence, with two cases showing isolated chest recurrence. PET-CT accuracy exceeded CT for body 92% (49/53) vs. 83% (44/53), chest 96% (51/53) vs. 89% (47/53), and abdomen 91% (48/53) vs. 79% (42/53). ROC curves for PET-CT dominated that for CT alone; this difference was statistically significant for abdomen and for body overall (P < 0.01). Interobserver agreement was better for PET-CT than for CT alone.
  
  
  CONCLUSIONS
  PET-CT demonstrates greater accuracy and less interobserver variability than CT alone.
authors.affiliation: Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, White 270, Boston, MA 02114, USA.
authors.forename: Sunit
authors.initials: S
authors.lastname: Sebastian
authors.forename: Susanna I
authors.initials: SI
authors.lastname: Lee
authors.forename: Neil S
authors.initials: NS
authors.lastname: Horowitz
authors.forename: James A
authors.initials: JA
authors.lastname: Scott
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Fischman
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Simeone
authors.forename: Arlan F
authors.initials: AF
authors.lastname: Fuller
authors.forename: Peter F
authors.initials: PF
authors.lastname: Hahn
mesh_terms: D000368:Aged; D003287:Contrast Media; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007479:Iopamidol; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D012372:ROC Curve; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D007479:Iopamidol