Role of18 F-FDG PET/CT in diagnosing peritoneal carcinomatosis in the restaging of patient with ovarian cancer as compared to contrast enhanced CT and tumor marker Ca-125

• Published in: Revista Española de medicina nuclear e imagen molecular (English ed.) 2013, Vol.33 (1), p.22-27
• Main Authors: Rubini, G, Altini, C, Notaristefano, A, Merenda, N, Rubini, D, Ianora, A.A. Stabile, Asabella, A. Niccoli
• Format: Article
• Language: English
• Subjects: Radiology
• ISSN: 2253-8089; 2253-8089
• DOI: 10.1016/j.remnie.2013.12.010

Abstract Objectives To investigate the role of whole-body fluorine-18-2-deoxy-2-fluoro- d -glucose positron emission tomography/computed tomography (18 F-FDG PET/CT) in the identification of peritoneal carcinomatosis in patients with ovarian cancer (OC). Material and methods Seventy-nine patients with histologically proven stages III–IV OC who underwent18 F-FDG PET/CT were studied retrospectively. We considered group A as 51 patients who also underwent computed-tomography with contrast-enhancement (CECT), and group B as 35 patients who had also been tested for biomarker Ca-125. Sensitivity, specificity, accuracy, positive predictive values (PPV) and negative predictive values (NPV) of18 F-FDG PET/CT as compared to CECT and to Ca-125 were evaluated. Results18 F-FDG PET/CT’ sensitivity, specificity, accuracy, PPV and NPV for all 79 patients were: 85%, 92.31%, 88.61%, 91.89% and 85.71%, respectively.18 F-FDG PET/CT sensitivity in group A was 78.6%, while it was 53.6% for CECT.18 F-FDG PET/CT specificity, calculated in the same group, was 91.3%, while that of CECT was 60.9% (statistically significant difference, McNemar 4, P = 0.039). Accuracy was 84.3% and 56.9%, respectively.18 F-FDG PET/CT’ sensitivity in group B was 86.4%, while that of Ca-125 was 81.8% (no statistical difference, McNemar 0, P = 1).18 F-FDG PET/CT specificity in group B was 84.6% while that of Ca-125 was 38.5% (clear but not statistically significant difference, McNemar 3.12, P = 0.070). Accuracy calculated in the same group was 85.7% for18 F-FDG PET/CT and 65.7% for Ca-125. Conclusion18 F-FDG PET/CT is a useful diagnostic tool when peritoneal biopsy cannot be performed and it can better select those who are candidates for adjuvant chemotherapy.