正子造影卵巢氟-18-FDG攝取與月經週期之研究

Abstract

Background: Positron emission tomography (PET) is an important diagnostic tool in clinical application. For the diagnosis of malignant tumor by FDG-PET scan, the normal physiological distribution and benign pathology of FDG uptake must be understood. Increased FDG accumulation in the ovaries, if shown by FDG-PET images of women, may be associated with normal physiological uptake of ovary or tumor uptake. The purpose of this study is to assess the correlation between ovarian FDG uptake and menstrual cycle of women. Methods: Sixty healthy premenopausal woman examinees (mean age 41.2±5.9) whose FDG-PET images showed ovarian uptake in the menstrual cycle were enrolled retrospectively in this study. The menstrual cycle was divided into four stages: menstruation, follicular phase, ovulation, and luteal phase. We analyzed imaging results based on various stages. Results: Among 60 women with ovarian FDG uptake in the menstrual cycle, none in menstruation period, 3 in follicular phase (average SUV(subscript max); 4.39±0.30), 25 in ovulation period (average SUV(subscript max): 4.37±1.38), 32 in luteal phase (average SUV(subscript max): 4.37±1.43). Thirty-six women have ovarian uptake on the right side, 23 on the left side, and 1 on both sides. Conclusion: Increased FDG accumulation in the ovary of premenopausal women especially during the ovulation and luteal phases of menstrual cycle, if combined with normal size and CA-125 level, can be considered normal physiological ovarian uptake. On the other hand, further examination in concern for malignancy should be advised if increased FDG uptake is shown in the ovary of a post-menopausal woman. Inquiring and recording the menstrual history of the women referred for FDG-PET study is helpful to imaging diagnosis and also avoiding false-positive results.