Role of 18F-FDG PET/CT in diagnosing peritoneal carcinomatosis in the restaging of patient with ovarian cancer as compared to contrast enhanced CT and tumor marker Ca-125.
OBJECTIVE
To investigate the role of whole-body fluorine-18-2-deoxy-2-fluoro-d-glucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) in the identification of peritoneal carcinomatosis in patients with ovarian cancer (OC).


METHODS
Seventy-nine patients with histologically proven stages III-IV OC who underwent (18)F-FDG PET/CT were studied retrospectively. We considered group A as 51 patients who also underwent computed-tomography with contrast-enhancement (CECT), and group B as 35 patients who had also been tested for biomarker Ca-125. Sensitivity, specificity, accuracy, positive predictive values (PPV) and negative predictive values (NPV) of (18)F-FDG PET/CT as compared to CECT and to Ca-125 were evaluated.


RESULTS
(18)F-FDG PET/CT' sensitivity, specificity, accuracy, PPV and NPV for all 79 patients were: 85%, 92.31%, 88.61%, 91.89% and 85.71%, respectively. (18)F-FDG PET/CT sensitivity in group A was 78.6%, while it was 53.6% for CECT. (18)F-FDG PET/CT specificity, calculated in the same group, was 91.3%, while that of CECT was 60.9% (statistically significant difference, McNemar 4, P=0.039). Accuracy was 84.3% and 56.9%, respectively. (18)F-FDG PET/CT' sensitivity in group B was 86.4%, while that of Ca-125 was 81.8% (no statistical difference, McNemar 0, P=1). (18)F-FDG PET/CT specificity in group B was 84.6% while that of Ca-125 was 38.5% (clear but not statistically significant difference, McNemar 3.12, P=0.070). Accuracy calculated in the same group was 85.7% for (18)F-FDG PET/CT and 65.7% for Ca-125.


CONCLUSIONS
(18)F-FDG PET/CT is a useful diagnostic tool when peritoneal biopsy cannot be performed and it can better select those who are candidates for adjuvant chemotherapy.
D.I.M. - Diagnostic Imaging - Nuclear Medicine, University of Bari "Aldo Moro", Bari, Italy.
G
G
Rubini
D.I.M. - Diagnostic Imaging - Nuclear Medicine, University of Bari "Aldo Moro", Bari, Italy.
C
C
Altini
D.I.M. - Diagnostic Imaging - Nuclear Medicine, University of Bari "Aldo Moro", Bari, Italy.
A
A
Notaristefano
D.I.M. - Diagnostic Imaging - Nuclear Medicine, University of Bari "Aldo Moro", Bari, Italy.
N
N
Merenda
D.I.M. - Diagnostic Imaging - Nuclear Medicine, University of Bari "Aldo Moro", Bari, Italy.
D
D
Rubini
D.I.M. - Radiodiagnostic Unit, University of Bari "Aldo Moro", Italy.
A A Stabile
AA
Ianora
D.I.M. - Diagnostic Imaging - Nuclear Medicine, University of Bari "Aldo Moro", Bari, Italy. Electronic address: artor.niccoliasabella@uniba.it.
A Niccoli
AN
Asabella
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018394:CA-125 Antigen / Q000097:blood*; D002277:Carcinoma / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D003287:Contrast Media; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007044:Hysterectomy; D008565:Membrane Proteins / Q000097:blood*; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging / Q000379:methods*; D010051:Ovarian Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery; D010052:Ovariectomy; D010534:Peritoneal Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
D018394:CA-125 Antigen; D003287:Contrast Media; C451759:MUC16 protein, human; D008565:Membrane Proteins; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
(18)F-FDG PET/CT; CT contraste; Ca-125; Contrast enhanced CT; Cáncer de ovario; Metástasis peritoneales; Ovarian cancer; Peritoneal metastases