Predictive value of PET-CT imaging versus AGO-scoring in patients planned for cytoreductive surgery in recurrent ovarian cancer.
OBJECTIVE
To assess the predictive value of positron emission tomography computed tomography (PET-CT) imaging in comparison to AGO-scoring in patients planned for cytoreductive surgery in recurrent ovarian cancer.


METHODS
33 patients who had received a PET-CT for suspicion of recurrent ovarian cancer between 12/2003 and 08/2007 were included in the retrospective analysis. Indication for PET-CT was based on blood tumor markers Ca 125 or Ca 72-4 and clinical symptoms. Scanning was performed on a Philips Gemini System covering the body from the neck to the thighs one hour after administration of 200MBq fluorodesoxyglucose. PET-CT, surgery and the patient records were reviewed to analyze the predictive value of PET-CT in comparison to an AGO-scoring system based on clinical parameters with regard to the prediction of full resectability of abdominal tumor spread.


RESULTS
The statistical analysis of this data showed a sensitivity of 73% (95% C.I., 39-94%) and specificity of 80% (95% C.I., 29-97%) for AGO-scoring with a positive predictive value of 89% and a negative predictive value of 57%. PET-CT achieved a sensitivity of 100% (95% C.I., 72-100%) and specificity of 60% (95% C.I. 15-94%), with a positive predictive value of 85% and negative predictive value of 100%. Further analysis of the data of operated patients with concordant PET-CT and AGO-score (12/16) showed a very good prediction of full resectability with a sensitivity of 100% (95% C.I., 63-100%), specificity of 75% (95% C.I., 20-96%), positive predictive value of 89% and negative predictive value of 100%.


CONCLUSIONS
PET-CT and the AGO-score offer good tools to determine patients for full resectability in recurrent ovarian cancer. PET-CT has a higher negative and the AGO score a higher positive predictive value, and the combination of both improves the diagnostic accuracy.
Lenhard
S M
SM
Department of Obstetrics and Gynecology, Ludwig-Maximilians-University Munich, Campus Grosshadern, Marchioninistrasse 15, 80337 Munich, Germany. Miriam.Lenhard@med.uni-muenchen.de
Burges
A
A
Johnson
T R C
TR
Kirschenhofer
A
A
Bruns
C
C
Linke
R
R
Friese
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000601:surgery; D009375:Neoplasms, Glandular and Epithelial / Q000175:diagnosis* / Q000601:surgery; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000601:surgery; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed