RT Journal Article
SR Electronic
T1 Assessment of nodal status by 18F-FDG PET/CT in early stage ovarian cancer
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 403
OP 403
VO 54
IS supplement 2
A1 Crivellaro, Cinzia
A1 Guerra, Luca
A1 Signorelli, Mauro
A1 De Ponti, Elena
A1 Dolci, Carlotta
A1 Pirovano, Cecilia
A1 Elisei, Federica
A1 Ceppi, Lorenzo
A1 Fruscio, Robert
A1 Messa, Cristina
YR 2013
UL http://jnm.snmjournals.org/content/54/supplement_2/403.abstract
AB 403 Objectives In early stage ovarian cancer, lymph node (LN) metastases occur in approximately 5-25%. A non-invasive modality that allows an accurate LN staging could reduce unnecessary surgical procedures, reducing morbidities. Aim of this study was to evaluate the accuracy of 18F-FDG PET/CT in the detection of LN metastases in clinical early stage ovarian cancer. Methods 68 pts (49 years; range 35-72) with a macroscopic tumor limited to the pelvis at standard staging procedure (clinical stage I-IIc), underwent preoperative FDG-PET/CT scan followed by total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, random peritoneal biopsies and systematic pelvic and abdominal lymphadenectomy. The mean number of dissected LNs was 46 per pt. PET/CT images were analyzed and correlated to histological findings of LN status according to pt-based and lesion-based analyses. Results PET/CT resulted negative at LN level in 57/68 pts (55 TN, 2 FN) and positive in 11/68 pts (10 TP, 1 FP). Incidence of LN metastases resulted 18%. On pt-based analysis, sensitivity, specificity, accuracy, negative and positive predictive value of PET/CT in detecting LN metastases were 83%, 98% 96%, 97%, 91% respectively. On a lesion-based analysis, considering overall 517 LN-sites, these values were 76%, 99%, 98%, 99%, 88%, respectively. Conclusions In clinical early stage ovarian cancer FDG PET/CT is an accurate tool for the nodal status assessment. Its high negative predictive value (97%) could be useful in selecting pts who may be spared lymphadenectomy. As PET/CT can accurately detect LNs metastases, it could be of help for an optimal surgical debulking.