Impact of positron emission tomography/computed tomography in the management of patients with epithelial ovarian carcinoma after treatment

Abstract

The aims of this study were to compare the usefulness and reliability of integrated whole-body positron emission tomography/computed tomography (PET/CT) using (18)F-fluorodeoxyglucose (FDG) with those of contrast-enhanced multidetector CT during regular follow-up in patients after initial treatment of ovarian cancer, to assess the impact of FDG-PET/CT on the confirmation of recurrence, restaging, and clinical management of patients, and to determine the incremental information provided by PET/CT. A retrospective review was performed on 19 ovarian cancer patients who underwent a total of 30 FDG-PET/CT and contrast-enhanced multidetector CT scans. The following information was obtained: the clinical information of the patients; the results of FDG-PET/CT and contrast-enhanced multidetector CT, particularly with regard to the impact on the diagnosis of recurrence; information on the localization and number of diseases; and the impact on subsequent clinical management. Both FDG-PET/CT and contrast-enhanced multidetector CT had very high sensitivity and specificity for the detection of recurrent ovarian cancer. Contrast-enhanced multidetector CT was considered the more accurate imaging modality for detecting recurrence, whereas FDG-PET/CT was proven more effective for detecting large numbers of small lesions. When comparing the impact on the choice of a management plan, both FDG-PET/CT and contrast-enhanced multidetector CT were found to be significantly effective at predicting the locations of recurrence. Both integrated FDG-PET/CT and contrast-enhanced multidetector CT are sensitive surveillance modalities for the detection of recurrent ovarian cancer; the use of both modalities aids decisions on treatment plans and may ultimately have a favorable impact on prognosis. However, contrast-enhanced multidetector CT is recommended for the regular follow-up for ovarian cancer patients after initial treatment.