Abstract
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Objectives Ovarian cancer has a high recurrent rate. A sensitive method for post-surgery monitoring is crucial for timely and appropriate management of the disease to reach a better survival. This study was designed to evaluate FDG PET in monitoring post-treatment ovarian cancer patients and its role in decision-making of a secondary cytoreductive surgery.
Methods Two groups of patients were enrolled from Feb. 2003 to Aug. 2010: Group 1 consists 67 patients who underwent 2~6 follow-up PET scans (175 studies in total) with an mean interval of 10 months. Other imaging reports and serum CA125 were used for comparison. Group 2 includes 17 patients who underwent 20 secondary cytoreductive surgeries after PET scans. The PET findings were compared with the surgery records site by site.
Results In group 1, PET is positive in 129 of 175 studies, 39 (30.2%) of them showed negative CA125; 2 studies were positive in CA125 while negative in PET, and one is due to a nonmalignant cystic lesion. In 46 PET-positive studies with CT and/or MR for comparison, 23 new lesions were revealed in 14 (30.4%) studies in PET. All 53 PET-negative studies, including 10 with suspicious lesions by other image modalities, were confirmed free of lesions by 6 months follow-ups. In group 2, a total of 121 nodal lesions were confirmed after surgery. The preoperative PET reported 93(76.9%) of them; false negative lesions were in small size. For 18 studies with intubercular or millet-like lesions, only 2 studies were positive in PET. None lesions were found in surgery in 9 PET-positive studies, which may result from physical uptake of bowls.
Conclusions FDG PET is an excellent method for monitoring post-treatment ovarian cancer, and may play an important role in the subsequent management of the disease, especially in guiding the secondary cytoreductive surgery