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Performance of integrated FDG–PET/contrast-enhanced CT in the diagnosis of recurrent ovarian cancer: comparison with integrated FDG–PET/non-contrast-enhanced CT and enhanced CT

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to evaluate the accuracy of integrated positron emission tomography and computed tomography (PET/CT) using 18F-fluorodeoxyglucose with IV contrast for depiction of suspected recurrent ovarian cancer and to assess the impact of PET/contrast-enhanced CT findings on clinical management, compared with PET/non-contrast-enhanced CT and CT component.

Methods

One hundred thirty-two women previously treated for ovarian cancer underwent PET/CT consisting of non-enhanced and contrast-enhanced CT for suspected recurrence. PET/contrast enhanced CT, PET/non-contrast-enhanced CT, and enhanced CT were interpreted by two experienced radiologists by consensus for each investigation. Lesion status was determined on the basis of histopathology, radiological imaging, and clinical follow-up for longer than 6 months.

Results

Patient-based analysis showed that the sensitivity, specificity, and accuracy of PET/contrast-enhanced CT were 78.8% (52 of 66), 90.9% (60 of 66), and 84.8% (112 of 132), respectively, whereas those of PET/non-contrast-enhanced CT were 74.2% (49 of 66), 90.9% (60 of 66), and 82.6% (109 of 132), respectively, and those of enhanced CT were 60.6% (40 of 66), 84.8% (56 of 66), and 72.7% (96 of 132), respectively. Sensitivity, specificity, and accuracy differed significantly among the three modalities (Cochran Q test: p = 0.0001, p = 0.018, and p < 0.0001, respectively). The findings of PET/contrast-enhanced CT resulted in a change of management for 51 of the 132 patients (39%) and had an effect on patient management in 16 patients (12%) diagnosed by enhanced CT alone and three patients (2%) diagnosed by PET/non-contrast-enhanced CT.

Conclusion

Integrated PET/contrast-enhanced CT is an accurate modality for assessing ovarian cancer recurrence and led to changes in the subsequent appropriate therapy.

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Acknowledgment

We thank Kennichi Kobayashi, Kouichi Asano, Kazufumi Suzuki, Kaoru Ishida, and Tomoyuki Sakamoto for their excellent technical assistance and generous support.

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Authors and Affiliations

  1. Departments of Radiology, Dokkyo University School of Medicine, 880 Kita-kobayashi, Mibu, Shimotuka-gun, Tochigi, 321-0293, Japan

    Kazuhiro Kitajima & Yasushi Kaji

  2. PET Center, Dokkyo Medical University Hospital, Mibu, Japan

    Kazuhiro Kitajima, Koji Murakami, Erena Yamasaki & Yasushi Domeki

  3. Departments of Obsteris and Gynecology, Dokkyo University School of Medicine, Mibu, Japan

    Ichio Fukasawa & Noriyuki Inaba

  4. Department of Environmental Medicine, Kochi University Medical School, Kochi, Japan

    Narufumi Suganuma

  5. Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan

    Kazuhiro Kitajima & Kazuro Sugimura

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  1. Kazuhiro Kitajima
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Correspondence to Kazuhiro Kitajima.

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Kitajima, K., Murakami, K., Yamasaki, E. et al. Performance of integrated FDG–PET/contrast-enhanced CT in the diagnosis of recurrent ovarian cancer: comparison with integrated FDG–PET/non-contrast-enhanced CT and enhanced CT. Eur J Nucl Med Mol Imaging 35, 1439–1448 (2008). https://doi.org/10.1007/s00259-008-0776-3

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  • DOI: https://doi.org/10.1007/s00259-008-0776-3

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