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FIGURE 2. PET/CT detects and characterizes pattern of metastatic spread. An 80-y-old woman with ovarian cancer, after surgery and chemotherapy, was assessed for recurrence suggested by elevated levels of CA-125 tumor marker. CT scan performed 16 d before present examination showed inconclusive findings in liver and renal cysts. (A) 18F-FDG PET study (coronal slices) demonstrates focal area of increased tracer uptake (marker) in right upper abdomen, adjacent to right kidney. (B) Transaxial slices at level of this suspected lesion show focus of increased 18F-FDG uptake on PET (left), localized by PET/CT (center) to mass (4 cm in diameter) in close proximity to duodenum, as demonstrated on CT (right). On basis of detection of single site of recurrence, it was decided to embark on curative approach, and patient was referred for surgery. Peritoneal metastasis was completely removed, and no other sites of disease were found in abdominal cavity. At follow-up 6 mo later, tumor marker had returned to normal levels, repeat PET/CT results were normal, and there was no evidence of active malignancy.
