Abstract
Background: Serum CA-125 is the most accurate tumor marker used for monitoring the therapeutic response of ovarian cancer, and observing the recurrence of disease if initial test results are high when cancer is first found. FDGPET/CT enables the evaluation of both metabolic activity and anatomy at the same location in the body, facilitating the recognition of local recurrence of ovarian cancer. The aim of this study is to compare the usefulness of serum CA- 125 and FDG-PET/CT for the early detection of recurrent ovarian cancer, and evaluate their effects on the clinical disease management. Methods: Fifty-five consecutive FDG-PET/CT analyses were performed on 44 patients who exhibited elevated serum CA-125 levels (≥ 35 U/mL) or progressive low-level increases in serum CA-125 levels (Group 1, n = 27), and those who exhibited no increase in serum CA-125 levels (Group 2, n = 28). The results were analyzed using histological data, disease progression, and clinical follow-up. Recurrence was defined as evidence of recurrent lesions within 6 months of the FDG-PET/CT scan. Any change in the planned management was calculated based on medical records. Results: Recurrence was evident in 28 patients. The FDGPET/ CT scan detected 25 cases of recurrent cancer and one case of second primary cancer in Group 1, and one case of recurrent cancer in Group 2. The overall sensitivity, specificity and accuracy were 92.9%, 96.3% and 94.5% respectively for both serum CA-125 and FDG-PET/CT. FDGPET/ CT induced changes in the planned management of 27.3% (15/55) of the patients: 51.9% (14/27) of Group 1 patients and 3.6% (1/28) of Group 2 patients (P ＜ 0.001). Conclusion: Serum CA-125 is a sensitive tumor marker in recurrent ovarian cancer. FDG-PET/CT can be used to localize recurrent lesions and affect the course of disease management. We concluded that FDG-PET/CT should be used to detect recurrent ovarian cancer in conjunction with serum CA-125.
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