Clinical usefulness of post-treatment FDG PET/CT in patients with ovarian malignancy.
OBJECTIVE
We aimed to evaluate the diagnostic and prognostic value of post-treatment fluorine-18-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in patients treated for ovarian malignancy.


METHODS
We retrospectively reviewed post-treatment PET/CT images of patients treated for histologically confirmed ovarian malignancy. The diagnostic accuracy of PET/CT for detection of disease recurrence or second primary malignancy was calculated, and the impact of PET/CT on patient management was evaluated. The association between PET/CT result and overall survival (OS) was assessed using Cox regression analysis.


RESULTS
In total, 416 PET/CT cases of 268 ovarian malignancy patients (mean age, 50 ± 13 years) were included. Of 416 cases, 87 (21 %) were interpreted as PET/CT positive and 329 as negative. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 98.8, 98.2, 98.3, 93.1 and 99.7 %, respectively. Of 362 cases for surveillance, changes in management occurred based on PET/CT in 38 (11 %). Of 54 cases with clinical suspicion, PET/CT ruled out disease recurrence in 9 (17 %). The median follow-up period from PET/CT imaging was 26.7 months, and 24 patients (9 %) died during the follow-up period. In univariate analyses, age, FIGO stage, history of prior recurrence and PET/CT results were significantly associated with OS. PET/CT results remained significantly associated with OS in the multivariate analysis (p < 0.05).


CONCLUSIONS
Post-treatment PET/CT was a useful modality for the detection of disease recurrence or second primary malignancy that could improve the likelihood of proper treatment and help predict outcome in patients with ovarian malignancy.
Department of Radiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea.
Eun Ji
EJ
Han
Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Hye Lim
HL
Park
Department of Obstetrics and Gynecology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea.
Yong Seok
YS
Lee
Department of Obstetrics and Gynecology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea.
Eun Kyung
EK
Park
Department of Obstetrics and Gynecology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea.
Min Jong
MJ
Song
Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Ie Ryung
IR
Yoo
Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Sung Hoon
SH
Kim
Department of Radiology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 93, Jungbu-daero, Paldal-gu, Suwon, Gyeonggi-Do, 16247, Korea. wh0522@catholic.ac.kr.
Woo Hee
WH
Choi
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D000072078:Positron Emission Tomography Computed Tomography; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D055815:Young Adult
D019788:Fluorodeoxyglucose F18
Diagnostic accuracy; FDG PET/CT; Prognosis; Recurrent ovarian malignancy