title: Impact of FDG PET-CT imaging on the decision making in the biologic suspicion of ovarian carcinoma recurrence.
abstract: OBJECTIVE
  The aim of this prospective study was to evaluate the impact of integrated PET-CT on treatment management in ovarian carcinoma recurrence suspicion because of increased CA-125.
  
  
  METHODS
  Twenty-nine patients (mean age=61 years), initially treated for ovarian carcinoma (FIGO stage I n=2, stage II n=3, stage III n=21 and stage IV n=3), presenting with increased CA-125 (mean=160 IU/ml, range 33-1930), underwent subsequently a CT and a PET-CT scans. The recurrence was acknowledged by the referring physicians for all patients. The impact of PET-CT on patient's management was evaluated by comparing the therapeutic decision mentioned respectively on the pre and post PET-CT questionnaires filled in by the oncologists.
  
  
  RESULTS
  The CT scan was positive in 22/29 patients (76%) and negative in 7/29 patients (24%). The PET-CT scan was positive in 27/29 patients (93%) and negative in 2/29 (7%) patients. Five out of the seven patients with a negative CT scan had a positive PET-CT scan. In comparison to CT scan alone, the PET-CT scan modified the disease distribution for 16 patients (55%; p<0.001) in the following ways: more advanced disease (n=11), more limited disease (n=4), and different localizations (n=1). The assessment of pre and post PET-CT questionnaires showed a statistically significant change in the decision making for 10 patients (34%, p<0.0001).
  
  
  CONCLUSIONS
  This questionnaire-based study showed that PET-CT imaging allows a better restaging than CT and induces a change in clinical management in over one third of patients with suspected ovarian carcinoma recurrence on increased CA-125.
authors.affiliation: Nuclear Medicine Department, Rene Huguenin Cancer Research Center, Saint-Cloud, France.
authors.forename: Michael
authors.initials: M
authors.lastname: Soussan
authors.forename: Myriam
authors.initials: M
authors.lastname: Wartski
authors.forename: Pascal
authors.initials: P
authors.lastname: Cherel
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Fourme
authors.forename: Alain
authors.initials: A
authors.lastname: Goupil
authors.forename: Elise
authors.initials: E
authors.lastname: Le Stanc
authors.forename: Nasrine
authors.initials: N
authors.lastname: Callet
authors.forename: Jérôme
authors.initials: J
authors.lastname: Alexandre
authors.forename: Alain-Paul
authors.initials: AP
authors.lastname: Pecking
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Alberini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018394:CA-125 Antigen / Q000097:blood; D003657:Decision Making; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000000981:diagnostic imaging* / Q000628:therapy; D010051:Ovarian Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000628:therapy; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed
chemical_list: D018394:CA-125 Antigen; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18