title: Positron emission tomography in the management of documented or suspected recurrent ovarian cancer.
abstract: BACKGROUND
  To prospectively evaluate the value of positron emission tomography (PET) or integrated computed tomography (CT) and PET (PET/CT) in the management of documented or suspected recurrent ovarian cancer.
  
  
  METHODS
  Patients with ovarian cancer who had completed primary cytoreductive surgery and standard adjuvant chemotherapy were studied to evaluate the following indications: (1) CA125 elevation after complete remission with negative CT or magnetic resonance imaging (MRI) result; (2) post-therapy surveillance CT/MRI-detected suspicious lesions that guided biopsy was not feasible; (3) documented relapse for restaging prior to or after curative salvage therapy. The clinical impact of PET, as compared with those of CT/MRI, was determined on a per scan basis.
  
  
  RESULTS
  From 2002 to 2009, 73 patients were recruited, and 92 PET scans were performed. Up to June 2015, 53 patients had died of disease, four were alive with disease, and the remaining 16 were alive without disease. Among the 92 scans, PET had positive impacts in 72.8%, no clinical impacts in 21.7%, and negative impacts in 5.4%. For indication 1, the sensitivity and positive predictive value of PET in detecting recurrence were 80.0% and 92.3%, respectively. For indication 2, the sensitivity, specificity, positive predictive value, and negative predictive value of PET were 91.2%, 62.5%, 91.2%, and 62.5%, respectively. For indication 3, PET provided positive impact in 85.3% and negative impact in 2.9% of the 34 scans.
  
  
  CONCLUSIONS
  PET has value in the management of suspected or documented recurrent ovarian cancer, with positive impacts on confirming recurrent status and offering a better treatment plan.
authors.affiliation: Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital Linkou Medical Centre, Taoyuan, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan; Gynaecologic Cancer Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan. Electronic address: ma2012@cgmh.org.tw.
authors.forename: Hung-Hsueh
authors.initials: HH
authors.lastname: Chou
authors.affiliation: Gynaecologic Cancer Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Obstetrics and Gynaecology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan; Chang Gung University College of Medicine, Chiayi, Taiwan.
authors.forename: Chao-Yu
authors.initials: CY
authors.lastname: Chen
authors.affiliation: Chang Gung University College of Medicine, Taoyuan, Taiwan; Gynaecologic Cancer Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Feng-Yuan
authors.initials: FY
authors.lastname: Liu
authors.affiliation: Chang Gung University College of Medicine, Taoyuan, Taiwan; Gynaecologic Cancer Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Gigin
authors.initials: G
authors.lastname: Lin
authors.affiliation: Chang Gung University College of Medicine, Taoyuan, Taiwan; Gynaecologic Cancer Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Radiation Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Chun-Chieh
authors.initials: CC
authors.lastname: Wang
authors.affiliation: Chang Gung University College of Medicine, Taoyuan, Taiwan; Gynaecologic Cancer Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Biostatistics Unit, Clinical Trial Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Lan-Yan
authors.initials: LY
authors.lastname: Yang
authors.affiliation: Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital Linkou Medical Centre, Taoyuan, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan; Gynaecologic Cancer Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Min-Yu
authors.initials: MY
authors.lastname: Chen
authors.affiliation: Biostatistics Unit, Clinical Trial Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Yu-Bin
authors.initials: YB
authors.lastname: Pan
authors.affiliation: Chang Gung University College of Medicine, Taoyuan, Taiwan; Gynaecologic Cancer Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Pathology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Ren-Chin
authors.initials: RC
authors.lastname: Wu
authors.affiliation: Chang Gung University College of Medicine, Taoyuan, Taiwan; Gynaecologic Cancer Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Tzu-Chen
authors.initials: TC
authors.lastname: Yen
authors.affiliation: Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital Linkou Medical Centre, Taoyuan, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan; Gynaecologic Cancer Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Ting-Chang
authors.initials: TC
authors.lastname: Chang
authors.affiliation: Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital Linkou Medical Centre, Taoyuan, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan; Gynaecologic Cancer Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan. Electronic address: sh46erry@ms6.hinet.net.
authors.forename: Chyong-Huey
authors.initials: CH
authors.lastname: Lai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D000072078:Positron Emission Tomography Computed Tomography; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013624:Taiwan
keywords: (18)F-FDG fluorodeoxyglucose; computed tomography; magnetic resonance imaging; ovarian cancer; positron emission tomography; recurrent