Detection of recurrent ovarian cancer at MRI: comparison with integrated PET/CT.
OBJECTIVE
To compare the diagnostic performances of magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) for the detection of recurrent ovarian tumor.


METHODS
Thirty-six patients who underwent primary cytoreductive surgery for ovarian carcinoma received both MRI and PET/CT for the evaluation of ovarian tumor recurrence. Recurrent ovarian tumors in abdomen and pelvis were classified based on site as follows: (1) local pelvic recurrence, (2) peritoneal lesion, (3) lymph nodal metastasis, and (4) distant metastasis. Patient-based and lesion-based analyses were retrospectively performed with the aim of detecting tumor recurrence. For the detection of recurrent ovarian tumors, we compared patient-based and lesion-based diagnostic accuracies of these 2 modalities using the McNemar test.


RESULTS
Histopathologic, clinical, and radiological follow-up findings revealed recurrent ovarian tumors in 35 sites of 22 patients. These 35 sites consisted of local pelvic recurrence (n = 15), peritoneal lesions (n = 14), lymph nodal metastasis (n = 4), and abdominal wall metastasis (n = 2). In detecting recurrent ovarian tumor, patient-based sensitivity and the accuracy of PET/CT and MRI were 73% and 91% (P < 0.05), and 81% and 89% (P > 0.05), respectively. In addition, overall lesion-based sensitivity of PET/CT and MRI were 66% and 86%, respectively (P < 0.05). In detecting peritoneal lesions, overall lesion-based sensitivity and accuracy of PET/CT and MRI for peritoneal lesions were 43% and 86%, and 75% and 94%, respectively (P < 0.05).


CONCLUSIONS
Magnetic resonance imaging is more sensitive than PET/CT for detecting local pelvic recurrence and peritoneal lesions of recurrent ovarian tumors.
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul.
Chan Kyo
CK
Kim
Byung Kwan
BK
Park
Joon Young
JY
Choi
Byoung-Gie
BG
Kim
Heon
H
Han
D000008:Abdominal Neoplasms / Q000556:secondary; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018283:Cystadenocarcinoma, Papillary / Q000175:diagnosis / Q000000981:diagnostic imaging; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008207:Lymphatic Metastasis / Q000175:diagnosis / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000000981:diagnostic imaging; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D010534:Peritoneal Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18