Abstract
Objectives:To investigate the role of 18F-FDG positron emission tomography/computed tomography (PET/CT) in detection of recurrence in ovarian cancer patients with increased CA-125 levels.Methods:Fifty-two patients (30-80 years old, mean: 58.5±10.6 years) who had been histopathologically diagnosed with ovarian cancer, underwent 18F-FDG PET/CT imaging for re-staging due to elevation of CA-125 levels were included in this retrospective study. 18F-FDG PET/CT findings were compared with histopathological, radiological and clinical follow-up results.Results:CA-125 levels ranged between 35.2-2740 U/mL (N: 0-35 U/mL). Recurrent disease was detected in 45 of 52 patients on PET/CT imaging. There were three false negative and one false positive result. In addition to abdominal and pelvic lesions, 14 distant metastatic lesions (brain, lung, liver and bone metastasis) were identified correctly on PET/CT imaging. Sensitivity, specificity, positive and negative predictive value and accuracy of 18F-FDG PET/CT were calculated as 94%, 75%, 98%, 50% and 96%, respectively.Conclusion: 18F-FDG PET/CT is a useful imaging method that can be used in detection of ovarian cancer recurrence in patients with elevated CA-125 levels. Since this modality offers whole body imaging, distant metastases could be detected in addition to abdominal and pelvic lesions thus contributing to patient management.
Highlights
Ovarian cancer is the fourth leading cause of cancer death among women [1]
Oral contrast was given to all patients. 18F-FDG positron emission tomography/computed tomography (PET/CT) imaging was performed after a resting period of 60 minutes by using Siemens (Biograph mCT 20) and General Electric (GE, Discovery 610) PET/CT scanners
A total of 52 patients with a diagnosis of ovarian cancer were included in the study
Summary
Ovarian cancer is the fourth leading cause of cancer death among women [1]. It is usually diagnosed at advanced stages having poor prognosis. In spite of effective treatment and complete response, recurrence may occur in 50-80% of these patients [2,3,4]. Detection of recurrence is important for patient management. CA-125 is a high-molecular weight glycoprotein that is expressed at the cell-surface of epithelial cells. Serum CA125 levels are the reference method for the detection of ovarian carcinoma recurrences with a very high positive predictive value (PPV). CA-125 is not specific for ovarian cancer in addition to not being sensitive especially for small-volume disease [5,6]
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