Relationship of PET/CT characteristic manifestations and pathology in ovarian sex cord-stromal tumor

Abstract

Objective To investigate the value of PET/CT in the diagnosis of ovary sex cord-stromal tumor (SCST), and the correlation of PET/CT findings with pathological features. Methods PET/CT findings of 40 patients (median age 57 years) with ovary SCST confirmed by pathology from November 2011 to December 2015 in Shengjing Hospital were retrospectively analyzed. ROI was drawn and SUVmax was calculated. The correlation of imaging features with pathological structural features was analyzed. Two-sample t test and one-way analysis of variance were used. Results Pathological results showed 27 patients were ovarian thecoma-fibroma group (20 patients with theca cell tumor, 7 patients with fibroma), 12 patients had granulosa cell tumor and 1 patient had sertoli-leydig cell tumor. Solid mass with or without cystic low-density area was found in 24 patients, 14 cases were cystic-solid tumors, and 2 cases showed cystic mass with irregular and thickened septations. SUVmax between solid and cystic-solid tumors was not significantly different (2.94±1.64 vs 3.77±1.40; t=2.325, P>0.05). There was no significant difference of SUVmax among theca cell tumors, fibromas and granulosa cell tumors(3.00±1.42, 2.32±1.04 and 3.68±1.65, respectively; F=2.036, P>0.05). Slight or moderate 18F-FDG uptake in solid component was demonstrated in 35 patients (SUVmax 2.96±1.25). Other 5 cases with high 18F-FDG uptake (SUVmax 6.31±0.96) were confirmed malignancy or malignant potential by pathological results, including 2 solid theca cell tumors, 2 cystic-solid granulosa cell tumors and 1 solid sertoli-leydig cell tumor. Conclusion There are some features to diagnose ovary SCST on 18F-FDG PET/CT imaging, which have some correlation with pathological features. Key words: Ovarian neoplasms; Sex cord-gonadal stromal tumors; Positron-emission tomography; Tomography, X-ray computed; Deoxyglucose