title: Increase in post-therapy tumor calcification on CT scan is not an indicator of response to therapy in low-grade serous ovarian cancer.
abstract: The aim of the study was to determine if increasing post-therapy calcification in peritoneal metastases in recurrent low-grade serous ovarian carcinomas indicated response to therapy.
  
  
  
  Retrospective analysis of patients with histologically confirmed, recurrent low-grade serous ovarian carcinoma who received treatment at our institution between 2000 and 2014 was performed. Only patients who had calcified tumor implants and showed either interval increase or decrease in tumor calcification following therapy were included in the study. Pre- and post-therapy CT scans of these patients were reviewed by 2 radiologists independently. Changes in the tumor calcification status and tumor deposits size were correlated with serum CA-125 levels. Fisher's exact test was used to assess the association between peritoneal deposit and calcification status with serum CA-125 status.
  
  
  
  35 Patients were included in the study. Based on serial serum CA 125 levels, 22 patients (63%) had progressive disease, 12 (34%) had partial response and 1 (3%) had stable disease. Using RECIST 1.1, 16 had progressive disease, 3 had partial response and 16 had stable disease. In the patients with progressive disease, post-therapy tumor calcification increased in 77% and decreased in 23%. Fischer's exact test showed that serum CA 125 change was significantly associated with change in size of peritoneal deposits and calcification change.
  
  
  
  This preliminary study shows that post-therapy increase in peritoneal implant calcification in low-grade serous ovarian carcinomas is not an indicator of response to therapy.
authors.affiliation: Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Pickens Academic Tower, 1400 Pressler Street, Unit 1473, Houston, TX, 77030-4009, USA. dganeshan@mdanderson.org.
authors.forename: Dhakshinamoorthy
authors.identifier: 0000-0001-5027-3347
authors.initials: D
authors.lastname: Ganeshan
authors.affiliation: Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Pickens Academic Tower, 1400 Pressler Street, Unit 1473, Houston, TX, 77030-4009, USA.
authors.forename: Priya
authors.initials: P
authors.lastname: Bhosale
authors.affiliation: Department of Biostatistics, University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030-4009, USA.
authors.forename: Wei
authors.initials: W
authors.lastname: Wei
authors.affiliation: Department of Pathology, University of Texas MD Anderson Cancer Center, Pickens Academic Tower, 1400 Pressler Street, Unit 1473, Houston, TX, 77030-4009, USA.
authors.forename: Preetha
authors.initials: P
authors.lastname: Ramalingam
authors.affiliation: Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Pickens Academic Tower, 1400 Pressler Street, Unit 1473, Houston, TX, 77030-4009, USA.
authors.forename: Eniola
authors.initials: E
authors.lastname: Mudasiru-Dawodu
authors.affiliation: Department of Gynecologic Oncology & Reproductive Medicine, University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030-4009, USA.
authors.forename: David
authors.initials: D
authors.lastname: Gershenson
authors.affiliation: Department of Gynecologic Oncology & Reproductive Medicine, University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030-4009, USA.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Sun
authors.affiliation: Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Pickens Academic Tower, 1400 Pressler Street, Unit 1473, Houston, TX, 77030-4009, USA.
authors.forename: Revathy
authors.initials: R
authors.lastname: Iyer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000150:complications / Q000473:pathology* / Q000628:therapy*; D010534:Peritoneal Neoplasms / Q000150:complications / Q000556:secondary*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: CT scan; Ovarian carcinoma; Tumor marker