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

  • Kazuhiro Kitajima
  • Koji Murakami
  • Erena Yamasaki
  • Yasushi Domeki
  • Yasushi Kaji
  • Ichio Fukasawa
  • Noriyuki Inaba
  • Narufumi Suganuma
  • Kazuro Sugimura
Original Article

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.

Keywords

Ovarian cancer Recurrence 18F-FDG PET/CT 

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Kazuhiro Kitajima
    • 1
    • 2
    • 5
  • Koji Murakami
    • 2
  • Erena Yamasaki
    • 2
  • Yasushi Domeki
    • 2
  • Yasushi Kaji
    • 1
  • Ichio Fukasawa
    • 3
  • Noriyuki Inaba
    • 3
  • Narufumi Suganuma
    • 4
  • Kazuro Sugimura
    • 5
  1. 1.Departments of RadiologyDokkyo University School of MedicineMibu, Shimotuka-gunJapan
  2. 2.PET CenterDokkyo Medical University HospitalMibuJapan
  3. 3.Departments of Obsteris and GynecologyDokkyo University School of MedicineMibuJapan
  4. 4.Department of Environmental MedicineKochi University Medical SchoolKochiJapan
  5. 5.Department of RadiologyKobe University Graduate School of MedicineKobeJapan

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