Abstract
Integrated FDG-PET/CT has been used successfully for the diagnosis, staging, restaging, therapy monitoring and prognostic prediction of ovarian cancer as well as various other malignant tumors. Compared with conventional PET/non-contrast CT images, combined PET/contrast-enhanced CT images with intravenous iodine contrast medium and sufficient radiation dose may contribute to a more accurate diagnosis with higher confidence. In the future, tracers other than FDG and integrated PET/MRI will be realized. We herein review the place and role of FDG-PET/CT in the management of ovarian cancer, discussing its usefulness and limitations in the imaging of these patients.
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Bristow RE, Duska LR, Lambrou NC, Fishmann EK, O’Neill MJ, Trimble EL, et al. A model for predicting surgical outcome in patients with advanced ovarian carcinoma using computed tomography. Cancer. 2000;89:1532–40.
Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T, et al. Cancer statistics, 2008. CA Cancer J Clin. 2008;58:71–96.
Beyer T, Townsend DW, Brun T, Kinahan PE, Charron M, Roddy R, et al. A combined PET/CT scanner for clinical oncology. J Nucl Med. 2000;41:1369–79.
von Schulthess GK, Steinert HC, Hany TF. Integrated PET/CT: current applications and future directions. Radiology. 2006;238:405–22.
Patel CN, Goldstone AR, Chowdhury FU, Scarsbrook AF. FDG PET/CT in oncology: “raising the bar”. Clin Radiol. 2010;65:522–35.
Adusumili S, Hussain HK, Caoili EM, Weadock WJ, Murray JP, Johnson TD, et al. MRI of sonographically indeterminate adnexal masses. AJR Am J Roentgenol. 2006;187:732–40.
Booth SJ, Turnbull LW, Poole DR, Richmond I. The accurate staging of ovarian cancer using 3T magnetic resonance imaging—a realistic option. BJOG. 2008;15:894–901.
Risum S, Hogdall C, Loft A, Berthelsen AK, Hogdall E, Nedergaard L, et al. The diagnostic value of PET/CT for primary ovarian cancer—a prospective study. Gynecol Oncol. 2007;105:145–9.
Castelluci P, Perrone AM, Picchio M, Ghi T, Farsad M, Nanni C, et al. Diagnostic accuracy of 18F-FDG PET/CT in characterizing ovarian lesions and staging ovarian cancer: correlation with transvaginal ultrasonography, computed tomography, and histology. Nucl Med Commun. 2007;28:589–95.
Nam EJ, Yun MJ, Oh YT, Kim JW, Kim JH, Kim S, et al. Diagnosis and staging of primary ovarian cancer: correlation between PET/CT, Doppler US, and CT or MRI. Gynecol Oncol. 2010;116:389–94.
Omura GA, Brady MF, Homesley HD, Yordan E, Major FJ, Buchsbaum HJ, et al. Long-term follow-up and prognostic factor analysis in advanced ovarian carcinoma: the Gynecologic Oncology Group experience. J Clin Oncol. 1991;9:1138–50.
Ricke J, Sehouli J, Hach C, Hanninen EL, Lichtenegger W, Felix R. Prospective evaluation of contrast-enhanced MRI in the depiction of peritoneal spread in primary or recurrent ovarian cancer. Eur Radiol. 2003;13:943–9.
Kitajima K, Murakami K, Yamasaki E, Kaji Y, Fukasawa I, Inaba N, et al. Diagnostic accuracy of integrated FDG-PET/contrast-enhanced CT in staging ovarian cancer: comparison with enhanced CT. Eur J Nucl Med Mol Imaging. 2008;35:1912–20.
Namimoto T, Awai K, Nakaura T, Yanaga Y, Hirai T, Yamashita Y. Role of diffusion-weighted imaging in the diagnosis of gynecological diseases. Eur Radiol. 2009;19:745–60.
Fujii S, Matsusue E, Kanasaki Y, Kanamori Y, Nakanishi J, Sugihara S, et al. Detection of peritoneal dissemination in gynecological malignancy: evaluation by diffusion-weighted MR imaging. Eur Radiol. 2008;18:18–23.
Chan YM, Ng TY, Ngan HY, Wong LC. Quality of life in women treated with neoadjuvant chemotherapy for advanced ovarian cancer: a prospective longitudinal study. Gynecol Oncol. 2003;88:9–16.
Schwarz JK, Grigsby PW, Dehdashti F, Celbeke D. The role of 18F-FDG PET in assessing therapy response in cancer of the cervix and ovaries. J Nucl Med. 2009;50:64S–73S.
Kitajima K, Murakami K, Yamasaki E, Domeki Y, Kaji Y, Fukasawa I, 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. 2008;35:1439–48.
Hauth EA, Antoch G, Stattaus J, Kuehl H, Veit P, Bosckisch A, et al. Evaluation of integrated whole-body PET/CT in the detection of recurrent ovarian cancer. Eur J of Radiol. 2005;56:263–8.
Nanni C, Rubello D, Farsad M, De Iaco P, Sansovini M, Erba P, et al. 18F-FDG PET/CT in the evaluation of recurrent ovarian cancer: a prospective study on forty-one patients. Eur J Surg Oncol. 2005;31:792–7.
Simcock B, Neesham D, Quinn M, Drummond E, Milner A, Hicks RJ. The impact of PET/CT in the management of recurrent ovarian cancer. Gynecol Oncol. 2006;103:271–6.
Chung HH, Kang WJ, Kim JW, Park NH, Song YS, Chung JK, et al. Role of [18F]FDG PET/CT in the assessment of suspected recurrent ovarian cancer: correlation with clinical or histological findings. Eur J Nucl Med Mol Imaging. 2007;34:480–6.
Mangili G, Picchio M, Sironi S, Vigano R, Rabaiotti E, Bornaghi D, et al. Integrated PET/CT as a first-line re-staging modality in patients with suspected recurrence of ovarian cancer. Eur J Nucl Med Mol Imaging. 2007;34:658–66.
Thrall MM, DeLoia JA, Gallion H, Avril N. Clinical use of combined positron emission tomography and computed tomography (FDG-PET/CT) in recurrent ovarian cancer. Gynecol Oncol. 2007;105:17–22.
Kim CK, Park BK, Choi JY, Kim BG, Han H. Detection of recurrent ovarian cancer at MRI: comparison with integrated PET/CT. J Comput Assist Tomogr. 2007;31:868–75.
Sebastian S, Lee SI, Horowitz NS, Scott JA, Fischman AJ, Simeone JF, et al. PET-CT vs. CT alone in ovarian cancer recurrence. Abdom Imaging. 2008;33:112–8.
Iagaru AH, Mittra ES, McDougall IR, Quon A, Gambhir SS. 18F-FDG PET/CT evaluation of patients with ovarian carcinoma. Nucl Med Commun. 2008;29:1046–51.
Soussan M, Wartski M, Cherel P, Fourme E, Goupil A, Le Stanc E, et al. Impact of FDG PET/CT imaging on the decision making in the biologic suspicion of ovarian carcinoma recurrence. Gynecol Oncol. 2008;108:160–5.
Fulham MJ, Carter J, Baldey A, Hicks RJ, Ramshaw JE, Gibson M. The impact of PET/CT in suspected recurrent ovarian cancer: a prospective multi-centre study as part of the Australian PET data collection project. Gynecol Oncol. 2009;112:462–8.
Makhija S, Howden N, Edwards R, Kelley J, Townsend DW, Meltzer CC. Positron emission tomography/computed tomography imaging for the detection of recurrent ovarian and fallopian tube carcinoma: a retrospective review. Gynecol Oncol. 2002;85:53–8.
Bristow RE, Del Carmen MG, Pannu HK, Cohade C, Zahurak ML, Fishman EK, et al. Clinically occult recurrent ovarian cancer: patient selection for secondary cytoreductive surgery using combined PET/CT. Gynecol Oncol. 2003;90:519–28.
Sironi S, Messa C, Mangili G, Zangheri B, Aletti G, Garevaglia E, et al. Integrated FDG-PET/CT in patients with persistent ovarian cancer: correlation with histologic findings. Radiology. 2004;233:433–40.
Pannu HK, Cohade C, Bristow RE, Fishman EK, Wahl RL. PET-CT detection of abdominal recurrence of ovarian cancer: radiologic-surgical correlation. Abdom Imaging. 2004;39:398–403.
Bristow RE, Giuntoli RL II, Pannu HK, Schulick RD, Fishman EK, Wahl RL. Combined PET/CT for detecting recurrent ovarian cancer limited to retroperitoneal lymph nodes. Gynecol Oncol. 2005;99:294–300.
Rose PG. Surgery for recurrent ovarian cancer. Semin Oncol. 2000;27:17–23.
Gu P, Pan LL, Wu SQ, Sun L, Huang G. CA125, PET alone, PET-CT, CT and MRI in diagnosing recurrent ovarian carcinoma: a systematic review and meta-analysis. Eur J Radiol. 2009;71:164–74.
Smith GT, Hubner KF, McDonald T, Thie JA. Cost analysis of FDG PET for managing patients with ovarian cancer. Clin Positron Imaging. 1999;2:63–70.
Kim S, Chung JK, Kang SB, Kim MH, Jeong JM, Lee DS, et al. [18F]FDG PET as a substitute for second-look laparotomy in patients with advanced ovarian carcinoma. Eur J Nucl Med Mol Imaging. 2004;31:196–201.
Nishiyama Y, Yamamoto Y, Kaneishi K, Ohno M, Hata T, Kushida Y, et al. Monitoring the neoadjuvant therapy response in gynecological cancer patients using FDG PET. Eur J Nucl Med Mol Imaging. 2008;35:287–95.
Avril N, Sassen S, Schmalfeldt B, Naehrig J, Rutke S, Weber WA, et al. Prediction of response to neoadjuvant chemotherapy by sequential F-18-fluorodeoxyglucose positron emission tomography in patients with advanced-stage ovarian cancer. J Clin Oncol. 2005;23:7445–53.
Kurosaki H, Oriuchi N, Okazaki A, Tamaki T, Uki A, Izuta M, et al. Prognostic value of FDG-PET in patients with ovarian carcinoma following surgical treatment. Ann Nucl Med. 2006;20:171–4.
Risum S, Hogdall C, Loft A, Berthelsen AK, Hogdall E, Nedergaard L, et al. Does the use of diagnostic PET/CT cause stage migration in patients with primary advanced ovarian cancer. Gynecol Oncol. 2010;116:395–8.
Kitajima K, Murakami K, Yamasaki E, Kaji Y, Sugimura K. Accuracy of integrated FDG-PET/contrast-enhanced CT in detecting pelvic and paraaortic lymph node metastasis in patients with uterine cancer. Eur Radiol. 2009;19:1529–36.
Kitajima K, Murakami K, Yamasaki E, Domeki Y, Kaji Y, Morita S, et al. Performance of integrated FDG-PET/contrast enhanced CT in the diagnosis of recurrent uterine cancer: comparison with PET alone and enhanced CT alone. Eur J Nucl Med Mol Imaging. 2009;36:362–72.
Kitajima K, Suzuki K, Nakamoto Y, Onishi Y, Sakamoto S, Senda M, et al. Low-dose non-enhanced CT versus full-dose contrast-enhanced CT in integrated PET/CT studies for the diagnosis of uterine cancer recurrence. Eur J Nucl Med Mol Imaging. 2010;37:1490–8.
Bunyaviroch T, Turkington TG, Wong TZ, Wilson JW, Colsher JG, Coleman RE. Quantitative effects of contrast enhanced CT attenuation correction on PET SUV measurements. Mol Imaging Biol. 2008;10:107–13.
Kumar R, Chauhan A, Jana S, Dadparvar S. Positron emission tomography in gynaecological malignancies. Expert Rev Anticancer Ther. 2006;6:1033–44.
Koyama K, Okamura T, Kawabe J, Ozawa N, Torii K, Umesaki N, et al. Evaluation of 18FDG PET with bladder irrigation in patients with uterine and ovarian tumors. J Nucl Med. 2003;44:353–8.
Belhocine T, Thille A, Fridman V, Albert A, Seidel L, Nickers P, et al. Contribution of whole-body 18FDG PET imaging in the management of cervical cancer. Gynecol Oncol. 2002;87:90–7.
Prakash P, Cronin CG, Blake MA. PET/CT in ovarian cancer. AJR Am J Roentgenol. 2010;194:W464–70.
Kim SK, Kang KW, Roh JW, Sim JS, Lee ES, Park SY. Incidental ovarian 18F-FDG accumulation on PET: correlation with the menstrual cycle. Eur J Nucl Med Mol Imaging. 2005;32:757–63.
Domingues RC, Carneiro MP, Lopes FCR, Domingues RC, Fonseca LMB, Gasparetto EL. Whole-body MRI and FDG PET fused images for evaluation of patients with cancer. AJR Am J Roentgenol. 2009;192:1012–20.
Yoshida Y, Kurokawa T, Tsujikawa T, Okazawa H, Kotsuji F. Positron emission tomography in ovarian cancer: 18F-deoxy-glucose and 16α-18F-fluoro-17β-estradiol(FES) PET. J Ovarian Res. 2009;2:7–16.
Torizuka T, Kanno T, Futatsubashi M, Okada H, Yoshikawa E, Nakamura F, et al. Imaging of gynaecologic tumor: comparison of 11C-Choline PET with 18F-FDG PET. J Nucl Med. 2003;44:1051–6.
Ludemann L, Sreenivasa G, Amthauer H, Michel R, Gellermann J, Wust P. Use of H 152 O-PET for investigating perfusion changes in pelvic tumors due to regional hyperthermia. Int J Hyperth. 2009;25:299–308.
Antoch G, Bockisch A. Combined. PET/MRI: a dimension of whole-body oncology imaging? Eur J Nucl Med Mol Imaging. 2009;36:S113–20.
Pichler BJ, Kolb A, Nagele T, Schlemmer HP. PET/MRI: paving the way for the next generation of clinical multimodality imaging applications. J Nucl Med. 2010;51:333–6.
Pichler BJ, Wehrl HF, Kolb A, Judenhofer MS. Positron emission tomography/magnetic resonance imaging: the next generation of multimodality imaging? Semin Nucl Med. 2008;38:199–208.
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Kitajima, K., Murakami, K., Sakamoto, S. et al. Present and future of FDG-PET/CT in ovarian cancer. Ann Nucl Med 25, 155–164 (2011). https://doi.org/10.1007/s12149-010-0449-8
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DOI: https://doi.org/10.1007/s12149-010-0449-8